Procalcitonin as a prognostic biomarker for stroke: A systematic review and meta-analysis

Abstract

Background & Objective: Stroke remains as an important cause of morbidity and mortality worldwide. Despite outcome prediction models available, determining functional outcomes remains a challenge hence there have been an increasing interest in novel prognostic biomarkers for stroke. Several studies have explored the prognostic significance of procalcitonin levels in determining functional outcomes and mortality in stroke patients. This study aims to systematically review articles and to determine if elevated procalcitonin is associated with poor functional outcomes and mortality.

Methods: Specific search terms were applied in Medline, Cochrane Library, ClinicalTrial.Gov, Global Index Medicus, and Herdin and studies were screened based on the inclusion and exclusion criteria.

Results: A total of 5 articles were deemed eligible for inclusion and there was no significant heterogeneity among them. Risk of bias was low based on the Quality in Prognostic Studies Tool and no significant bias was detected based on Egger’s test (p = 0.3560). Elevated procalcitonin levels were associated with an unfavorable functional outcome (OR 3.76; 95% CI 2.78-5.09) and mortality (OR 3.91; 95% CI 2.80-5.45) at 3 months to 1 year.

Conclusion: The findings of the study demonstrates procalcitonin’s potential role as a prognostic biomarker in stroke. Larger studies with broader geographic scope may further strengthen the evidence for procalcitonin’s role in stroke prognosis.