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.