Association between complement de-escalation and prognosis in sepsis: A systematic review and meta-analysis.
Xin Wei, Xin Lu, Xinzhu Liu et al.
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In 30 seconds
This systematic review and meta-analysis examined whether reduced complement activation after treatment was associated with prognosis in patients with sepsis. Eleven studies were included. Complement reduction was associated with lower IL-6, CRP, and APACHE II scores, but not with lower mortality: RR 1.04; 95% CI: 0.63, 1.71; P > 0.05. No significant differences were found in WBC, serum creatinine, or blood urea nitrogen. The findings suggest that changes in complement activation tracked with some inflammatory and severity measures, but did not demonstrate a mortality benefit.
Key findings
- Mortality was not lower with reduced complement levels: RR 1.04; 95% CI: 0.63, 1.71; P > 0.05.
- IL-6 decreased with complement reduction (MD: -196.83; 95% CI: -329.16, -64.49; P < 0.001).
- CRP decreased (MD: -9.09; 95% CI: -14.44 -3.74; P < 0.001), as did APACHE II scores (MD: -4.55; 95% CI: -6.98 -2.12; P < 0.001).
- WBC, serum creatinine, and blood urea nitrogen showed no significant differences.
Why it matters
Complement activation may change alongside inflammatory biomarkers and illness-severity scores in treated sepsis, but these pooled findings do not establish that such changes translate into improved survival. Distinguishing biomarker or score changes from patient-important outcomes is important when interpreting treatment response and evaluating complement-related measures as indicators of prognosis.
What to keep in mind
The meta-analysis included 11 studies, and the abstract does not report their designs or provide further detail on study quality or heterogeneity.