Neutrophil CD64 as a prognostic biomarker for mortality in sepsis: A systematic review and meta-analysis.

Objective: Sepsis remains a major cause of mortality worldwide. While neutrophil CD64 (nCD64) has demonstrated superior performance in detecting sepsis compared to conventional biomarkers, its prognostic value remains unclear. This meta-analysis evaluates the performance of nCD64 in predicting mortality in patients with sepsis.

Design: Systematic review and meta-analysis.

Settings: A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted up to January 28, 2025, to identify relevant studies.

Patients: Patients aged 16 years or older diagnosed with sepsis based on Sepsis-1, Sepsis-2, or Sepsis-3 criteria.

Interventions: Studies assessing the predictive accuracy of nCD64 for mortality and providing sufficient data for contingency table construction were included.

Main variables of interest: Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated with 95% confidence intervals (CIs). Overall predictive accuracy was assessed using the area under the summary receiver operating characteristic curve.

Results: Eight studies involving 756 patients were included. The pooled sensitivity, specificity, and DOR of nCD64 for predicting mortality were 0.79 (95% CI: 0.68-0.87), 0.67 (95% CI: 0.56-0.77), and 7.71 (95% CI: 4.38-13.57), respectively. The predictive accuracy was 0.80.

Conclusions: Our findings suggest that nCD64 may serve as a valuable auxiliary biomarker for identifying patients with sepsis at higher risk of mortality.