Utility of laboratory biomarkers as mortality predictors for melioidosis: A systematic review

Melioidosis, the “great mimicker,” is a frequently overlooked infectious disease with a high mortality rate. It is caused by Burkholderia pseudomallei . This systematic review aimed to identify consistent biochemical predictors of mortality among patients with melioidosis. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement, 2020. A systematic search was carried out in PubMed, Scopus, and Embase. Relevant data from the included studies were extracted. High heterogeneity among outcomes reported in the included studies prevented any formal meta-analysis. The relevant findings of individual studies were mentioned qualitatively. Hypoalbuminemia at presentation was the most consistently implicated predictor of mortality, followed by low serum bicarbonate, elevated serum creatinine and urea, and hyponatremia at presentation. Thrombocytopenia and elevated international normalized ratio were also associated with higher mortality. White blood cell indices showed heterogenous results for mortality risk. Hypoalbuminemia and low serum bicarbonate at presentation were the most commonly reported mortality risk factors in melioidosis patients.