Pneumonia Is Associated with Increased Mortality in Hospitalized COPD Patients: A Systematic Review and Meta-Analysis
Pneumonia Is Associated with Increased Mortality in Hospitalized COPD Patients: A Systematic Review and Meta-Analysis
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肺炎与住院 COPD 患者死亡率增加相关：系统评价和荟萃分析
DOI：
10.1159/000510615
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发表时间：
2021-01
期刊：
影响因子：
3.7
通讯作者：
Bing Mao
中科院分区：
文献类型：
--
作者：
Yan Yu;Wei Liu;Hongli Jiang;Bing Mao
背景：慢性阻塞性肺疾病（COPD）患者患肺炎的风险较高。共存的社区获得性肺炎（CAP）是否可以预测住院 COPD 患者死亡率的增加仍存在争议。目的：本系统回顾和荟萃分析旨在评估因呼吸道症状急性恶化而住院的 COPD 患者中 CAP 与死亡率和发病率之间的关联。方法：在本综述中，从成立到 2019 年 12 月的 4 个电子数据库中检索了调查 CAP 对住院 COPD 患者影响的队列研究和病例对照研究。使用纽卡斯尔-渥太华质量评估量表评估纳入研究的方法学质量。主要结局是死亡率。次要结局包括住院时间、机械通气需求、重症监护病房 (ICU) 入住、ICU 住院时间和再入院率。 Mantel-Haenszel法和逆方差法分别用于计算汇总相对风险（RR）和平均差（MD）。结果：共纳入 18 项研究。 CAP 的存在与较高的死亡率（RR = 1.85；95% CI：1.50–2.30；p < 0.00001）、较长的住院时间（MD = 1.89；95% CI：1.19–2.59；p < 0.00001）、更需要机械通气（RR = 1.48；95% CI： 1.32–1.67；p < 0.00001），住院 COPD 患者入住 ICU 的比例更高（RR = 1.58；95% CI：1.24–2.03；p = 0.0002）。 CAP 与较长的 ICU 住院时间（MD = 5.2；95% CI：-2.35 至 12.74；p = 0.18）或较高的再入院率（RR = 1.02；95% CI：0.96–1.09；p = 0.47）无关。结论：合并CAP可能与住院COPD患者死亡率和发病率增加有关，因此需要对CAP进行影像学确诊，并对这些患者给予更多关注。
Background: Patients with chronic obstructive pulmonary disease (COPD) are at a heightened risk of pneumonia. Whether coexisting community-acquired pneumonia (CAP) can predict increased mortality in hospitalized COPD patients is still controversial. Objective: This systematic review and meta-analysis aims to assess the association between CAP and mortality and morbidity in COPD patients hospitalized for acute worsening of respiratory symptoms. Methods: In this review, cohort studies and case-control studies investigating the impact of CAP in hospitalized COPD patients were retrieved from 4 electronic databases from inception until December 2019. Methodological quality of included studies was assessed using Newcastle-Ottawa Quality Assessment Scale. The primary outcome was mortality. The secondary outcomes included length of hospital stay, need for mechanical ventilation, intensive care unit (ICU) admission, length of ICU stay, and readmission rate. The Mantel-Haenszel method and inverse variance method were used to calculate pooled relative risk (RR) and mean difference (MD), respectively. Results: A total of 18 studies were included. The presence of CAP was associated with higher mortality (RR = 1.85; 95% CI: 1.50–2.30; p < 0.00001), longer length of hospital stay (MD = 1.89; 95% CI: 1.19–2.59; p < 0.00001), more need for mechanical ventilation (RR = 1.48; 95% CI: 1.32–1.67; p < 0.00001), and more ICU admissions (RR = 1.58; 95% CI: 1.24–2.03; p = 0.0002) in hospitalized COPD patients. CAP was not associated with longer ICU stay (MD = 5.2; 95% CI: −2.35 to 12.74; p = 0.18) or higher readmission rate (RR = 1.02; 95% CI: 0.96–1.09; p = 0.47). Conclusion: Coexisting CAP may be associated with increased mortality and morbidity in hospitalized COPD patients, so radiological confirmation of CAP should be required and more attention should be paid to these patients.
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DOI：
10.1016/s0140-6736(07)61382-8
发表时间：
2007-09-01
期刊：
Lancet (London, England)
影响因子：
--
作者：
Wedzicha JA;Seemungal TA
通讯作者：
Seemungal TA
COPD的肺炎与非脑急性加重。
影响因子：
9.6
作者：
Lieberman D;Lieberman D;Gelfer Y;Varshavsky R;Dvoskin B;Leinonen M;Friedman MG
通讯作者：
Friedman MG
影响因子：
7.7
作者：
Sanderson, Simon;Tatt, Lain D.;Higgins, Julian P. T.
通讯作者：
Higgins, Julian P. T.
影响因子：
10
作者：
Miravitlles, M;Ferrer, M;Vidal, R
通讯作者：
Vidal, R
影响因子：
2.9
作者：
Jeong, Seung Wook;Lee, Jae Hee;Kim, Chang Ho
通讯作者：
Kim, Chang Ho