Significances of miRNAs for predicting sepsis mortality: a meta-analysis.

Background: Sepsis is a life-threatening condition caused by a dysregulated immune response to infection and remains a major cause of mortality in intensive care units (ICUs). Recent studies have identified microRNAs (miRNAs), a class of small RNA molecules, as potential biomarkers for diagnosing and predicting outcomes in sepsis patients. However, the results of these studies have been inconsistent. This meta-analysis aims to comprehensively evaluate the diagnostic and prognostic value of miRNAs in predicting sepsis-related mortality. Methods: A comprehensive literature search was performed across major databases, including PubMed, Cochrane Library, EMBASE, and CNKI, up to April 7, 2024. Data extraction and meta-analysis were conducted using Meta-disk 1.4 and STATA 15.1, employing both fixed- and random-effects models to ensure robust statistical analysis. Results: A total of 55 studies met the inclusion criteria and were analyzed. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve for miRNA detection were calculated. The overall performance of total miRNA detection demonstrated a sensitivity of 0.76 (95% confidence interval [CI]: 0.74-0.77), a specificity of 0.72 (95% CI: 0.71-0.73), and an SROC value of 0.83. Subgroup analyses revealed that miR-133a-3p exhibited the highest diagnostic accuracy, with a pooled sensitivity of 0.83 (95% CI: 0.70-0.92), specificity of 0.79 (95% CI: 0.71-0.86), and an SROC value of 0.90. Additionally, other miRNAs, including miR-146a, miR-21, miR-210, miR-223-3p, miR-155, miR-25, miR-122, miR-125a, miR-125b, and miR-150, also demonstrated high SROC values (0.84 to 0.76). Conclusion: This meta-analysis underscores the potential of several microRNAs (miRNAs) as reliable biomarkers for predicting sepsis mortality. Specifically, miR-133a-3p, miR-146a, miR-21, miR-210, miR-223-3p, miR-155, miR-25, miR-122, miR-125b, and miR-150 emerge as promising candidates for clinical applications in sepsis prognosis.