AUTHOR=Tipoe Timothy L. , Wu William K. K. , Chung Lilianna , Gong Mengqi , Dong Mei , Liu Tong , Roever Leonardo , Ho Jeffery , Wong Martin C. S. , Chan Matthew T. V. , Tse Gary , Wu Justin C. Y. , Wong Sunny H. 

TITLE=Plasminogen Activator Inhibitor 1 for Predicting Sepsis Severity and Mortality Outcomes: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Immunology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2018.01218

DOI=10.3389/fimmu.2018.01218

ISSN=1664-3224

ABSTRACT=<sec id="ST1"><title>Objectives</title><p>Plasminogen activator inhibitor-1 (PAI-1), a crucial regulator of fibrinolysis, is increased in sepsis, but its values in predicting disease severity or mortality outcomes have been controversial. Therefore, we conducted a systematic review and meta-analysis of its predictive values in sepsis.</p></sec><sec id="ST2"><title>Methods</title><p>PubMed and Embase were searched until August 18, 2017 for studies that evaluated the relationships between PAI-1 levels and disease severity or mortality in sepsis.</p></sec><sec id="ST3"><title>Results</title><p>A total of 112 and 251 entries were retrieved from the databases, of which 18 studies were included in the final meta-analysis. A total of 4,467 patients (36% male, mean age: 62 years, mean follow-up duration: 36 days) were analyzed. PAI-1 levels were significantly higher in non-survivors than survivors [odds ratios (OR): 3.93, 95% confidence interval (CI): 2.31–6.67, <italic>P</italic> &lt; 0.0001] and in patients with severe sepsis than in those less severe sepsis (OR: 3.26, 95% CI: 1.37–7.75, <italic>P</italic> = 0.008).</p></sec><sec id="ST4"><title>Conclusion</title><p>PAI-1 is a significant predictor of disease severity and all-cause mortality in sepsis. Although the predictive values of PAI-1 reached statistical significance, the clinical utility of PAI-1 in predicting outcomes will require carefully designed prospective trials.</p></sec>