Network Meta-analysis was used to compare the predictive value of different detection indicators for bloodstream infection in ICU adult patients, providing evidence-based basis for early clinical diagnosis of bloodstream infection in patients.

Cochrane Library, PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure (CNKI), VIP, Wanfang database and SinoMed were searched by computer. All the experimental studies on different detection indicators for predicting bloodstream infection in ICU adult patients were collected. The retrieval time limit was from the establishment of the database to July 9, 2023.Two researchers independently searched and screened the literature according to the literature inclusion and exclusion criteria, strictly evaluated the quality of the included literature, extracted data, and used Revman5.4 software for Meta-analysis.

A total of 13 studies were included. The ranking results of network Meta-analysis showed that among different detection indicators, procalcitonin (PCT), C-reactive protein (CRP), combined with (IL-6) had the highest area under the cumulative rank probability curve for sensitivity, negative predictive value and accuracy (85.08%, 90.41%, 79.39%). PCT, hypersensitive-C-reactive protein(hs-CRP) combined with IL-6 had the highest area under the cumulative rank probability curve of specificity and positive predictive value (68.47%, 77.92%). The results of cluster analysis showed that PCT+hs-CRP+IL-6 and PCT+CRP+IL-6 were the farthest distance from the origin compared with other detection indicators.

PCT+CRP/hs-CRP+IL-6 can be used as a predictor for the diagnosis of bloodstream infection in ICU adult patients. In a single detection, pro-adrenomendullin may be the direction of future research, but due to the small sample size, the above conclusions need to be verified by more large sample and high quality studies.

Intensive care units; Forecasting; Meta-analysis; Detection indicators; Bloodstream infection; Diagnostic value