| | Review | Outcomes | Certainty assessment | Relative effect (95% CI) | Quality | | Design | Limitations | Inconsistency | Indirectness | Imprecision | Publication bias |
| | Chen et al. [17] 2018 | 28 days mortality | Rct | No | No | No | No | No | RR 0.54 (0.39, 0.73) | ⊕⊕⊕⊕⊕ high | | Duration of mechanical ventilation | Rct | No | No | No | No | No | SMD −1.13 (−1.30, −0.95) | ⊕⊕⊕⊕⊕ high | | Length of ICU stay | Rct | No | No | No | No | No | SMD −0.84 (−1.00, −0.67) | ⊕⊕⊕⊕⊕ high | | APACHE II score | Rct | No | Serious | No | No | No | SMD −1.09 (−1.49, −0.69) | ⊕⊕⊕⊕○ moderate | | Serum levels of PCT | Rct | Serious | Serious | No | No | No | SMD −1.61 (−2.23, −0.98) | ⊕⊕⊕○○ low |
| | Li et al. [18] 2018 | 28 days mortality | Rct | Serious | No | No | No | No | RR 0.62 (0.51, 0.76) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | Serious | No | No | No | MD = −3.51 (−4.49, −2.54) | ⊕⊕⊕○○ low | | White blood count | Rct | Serious | Serious | No | Serious | Serious | MD = −8.00 (−10.18, −5.82) | ⊕○○○○ very low | | Body temperature changes | Rct | Serious | No | No | No | No | MD = −0.43 (−0.55, −0.31) | ⊕⊕⊕⊕○ moderate |
| | Xiao et al. [19] 2018 | Duration of mechanical ventilation | Rct | Serious | No | No | No | No | SMD −0.90 (−1.07, −0.72) | ⊕⊕⊕⊕○ moderate | | Length of ICU stay | Rct | Serious | No | No | No | No | SMD −0.89 (−1.04, −0.73) | ⊕⊕⊕⊕○ moderate | | 28 days survival rate | Rct | Serious | No | No | No | No | RR 1.20 (1.08, 1.34) | ⊕⊕⊕⊕○ moderate | | Serum levels of PCT | Rct | Serious | Serious | No | No | No | SMD −0.57 (−0.77, −0.38) | ⊕⊕⊕○○ low | | APACHE II score | Rct | Serious | Serious | No | No | No | SMD −1.16 (−1.57, −0.75) | ⊕⊕⊕○○ low |
| | Zheng et al. [20] 2018 | 28 days mortality | Rct | Serious | No | No | No | No | RR 0.64 (0.43, 0.96) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | Serious | No | No | No | SMD −1.21 (−1.62, −0.80) | ⊕⊕⊕○○ low | | Duration of mechanical ventilation | Rct | Serious | Serious | No | No | No | SMD −1.04 (−1.40, −0.67) | ⊕⊕⊕○○ low | | Length of ICU stay | Rct | Serious | No | No | No | No | SMD −0.83 (−1.03, −0.64) | ⊕⊕⊕⊕○ moderate |
| | Xiao et al. [21] 2017 | 28 days mortality | Rct | Serious | No | No | No | Serious | RR 0.51 (0.44, 0.59) | ⊕⊕⊕○○ low | | APACHE II score | Rct | Serious | Serious | No | No | No | WMD −3.70 (−4.31, −3.09) | ⊕⊕⊕○○ low | | Serum levels of PCT | Rct | Serious | Serious | No | No | No | WMD −1.26 (−1.63, −0.88) | ⊕⊕⊕○○ low | | White blood count | Rct | Serious | Serious | No | No | No | WMD −1.48 (−2.03, −0.94) | ⊕⊕⊕○○ low | | Body temperature changes | Rct | Serious | Serious | No | No | No | WMD −0.50 (−0.92, −0.07) | ⊕⊕⊕○○ low |
| | Liu et al. [22] 2021 | 28 days mortality | Rct | Serious | No | No | No | No | RR 1.20 (1.15, 1.25) | ⊕⊕⊕⊕○ moderate | | White blood count | Rct | Serious | Serious | No | No | No | MD −1.95 (−3.62, −0.28) | ⊕⊕⊕○○ low | | Serum levels of PCT | Rct | Serious | Serious | No | No | No | MD −1.29 (−1.97, −0.62) | ⊕⊕⊕○○ low |
| | Zhang et al. [23] 2021 | 28 days mortality | Rct | Serious | No | No | No | No | OR 0.52 (0.38, 0.71) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | No | No | No | No | WMD −2.65 (−3.23, −2.08) | ⊕⊕⊕⊕○ moderate |
| | Zhou et al. [24] 2016 | 28 days mortality | Rct | Serious | No | No | Serious | No | RR 0.61 (0.41, 0.90) | ⊕⊕⊕○○ low |
| | Li et al. [25] 2016 | Effective rate | Rct | Serious | No | No | No | No | OR 2.90 (1.89, 4.47) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | No | No | No | No | MD −4.01 (−4.88, −3.13) | ⊕⊕⊕⊕○ moderate | | White blood count | Rct | Serious | No | No | Serious | Serious | MD −4.31 (−6.73, −1.89) | ⊕○○○○ very low | | Serum levels of PCT | Rct | Serious | No | No | Serious | Serious | MD −1.42 (−1.90, −0.95) | ⊕○○○○ very low |
| | Xu et al. [26] 2014 | 28 days survival rate | Rct | Serious | No | No | No | No | RR 1.21 (1.12, 1.29) | ⊕⊕⊕⊕○ moderate |
| | Li et al. [27] 2014 | 28 days mortality | Rct | Serious | No | No | No | No | OR 0.39 (0.27, 0.58) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | Serious | No | No | No | WMD −3.43 (−4.72, −2.15) | ⊕⊕⊕○○ low | | White blood count | Rct | Serious | No | No | Serious | Serious | WMD −2.94 (−3.49, −2.38 | ⊕○○○○ very low |
| | Sun et al. [28] 2012 | White blood count | Rct | Serious | Serious | No | No | No | WMD −1.87 (−2.92, −0.81) | ⊕⊕⊕○○ low |
| | Hu et al. [29] 2010 | 28 days mortality | Rct | Serious | Serious | No | No | No | RR 0.65 (0.54, 0.79) | ⊕⊕⊕○○ low |
| | Wu et al. [30] 2020 | 28 days mortality | Rct | Serious | No | No | No | No | RR 0.52 (0.40, 0.67) | ⊕⊕⊕⊕○ moderate | | APACHE II score | Rct | Serious | Serious | No | No | No | MD −5.48 (−7.52, −3.43) | ⊕⊕⊕○○ low | | White blood count | Rct | Serious | Serious | No | No | No | MD −2.26 (−3.35, −1.17) | ⊕⊕⊕○○ low | | C-reactive protein | Rct | Serious | Serious | No | No | No | MD −37.43 (−56.70, −18.16) | ⊕⊕⊕○○ low |
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ICU, intensive care unit; APACHE, acute physiology and chronic health evaluation; PCT, procalcitonin. RCT, randomized controlled trials; WMD, weighted mean difference; SMD, standard mean difference; MD, mean difference; OR, odds ratio; RR, relative risk.
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