Background

The role of blood high mobility group box-1 (HMGB-1) protein in predicting mortality of sepsis remains controversial.

Objective

Here we conducted a meta-analysis to seek evidence for the association between blood HMGB-1 concentrations and mortality in patients with sepsis.

Methods

Eligible studies were identified by a comprehensive search of six digital databases, supplemented by a manual search of related references. Standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs) were calculated as effect estimates.

Results

A total of eighteen studies, covering 1163 patients with sepsis, were included. Compared with survival groups of sepsis, non-survival groups had significantly higher blood HMGB-1 concentrations at enrollment (SMD: 0.45, 95% CI: 0.21–0.69). Subgroup analyses showed that no significant differences were found between two groups among patients with more severe sepsis (SMD: 0.18, 95% CI: -0.02–0.38). A significant association between initial HMGB-1 levels and ≤30-day mortality remained (SMD: 0.43, 95% CI: 0.09–0.78). Besides, HMGB-1 levels were observed to be more significantly higher in non-survival groups after the third day of admission (SMD: 1.33, 95% CI: 1.05–1.62) but two groups attained comparable HMGB-1 levels on day 7 (SMD: 1.01, 95% CI: -0.31–2.33).

Conclusions

Initial high blood HMGB-1 levels are significantly associated with short-term (≤30 days) mortality of patients with sepsis, and the association may be affected by the severity of sepsis. Subsequent monitoring of HMGB-1 levels, on the third and seventh day after admission, is encouraged for better evaluation of HMGB-1 as a prognostic marker of mortality in sepsis.

中文翻译：

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血液高迁移率族box-1蛋白与脓毒症患者死亡率的相关性：荟萃分析

背景

血液高迁移率族框 1 (HMGB-1) 蛋白在预测败血症死亡率中的作用仍存在争议。

客观的

在这里，我们进行了一项荟萃分析，以寻找血液 HMGB-1 浓度与败血症患者死亡率之间关联的证据。

方法

通过对六个数字数据库的全面搜索，并辅以对相关参考文献的手动搜索，确定了符合条件的研究。计算标准化平均差 (SMD) 和相应的 95% 置信区间 (CI) 作为效果估计值。

结果

共纳入 18 项研究，涵盖 1163 名败血症患者。与败血症存活组相比，非存活组在入组时的血液 HMGB-1 浓度显着更高（SMD：0.45，95% CI：0.21–0.69）。亚组分析显示，在更严重的败血症患者中，两组之间没有发现显着差异（SMD：0.18，95% CI：-0.02–0.38）。初始 HMGB-1 水平与≤30 天死亡率之间仍然存在显着关联（SMD：0.43，95% CI：0.09-0.78）。此外，在入院第三天后观察到非存活组的 HMGB-1 水平更显着更高（SMD：1.33，95% CI：1.05-1.62），但两组在第 7 天达到可比的 HMGB-1 水平（ SMD：1.01，95% CI：-0.31–2.33）。

结论

初始高血 HMGB-1 水平与脓毒症患者的短期（≤30 天）死亡率显着相关，并且这种关联可能受脓毒症严重程度的影响。鼓励在入院后第三天和第七天监测 HMGB-1 水平，以更好地评估 HMGB-1 作为败血症死亡率的预后标志物。