Respiratory syncytial virus hospitalization and mortality: Systematic review and meta-analysis.
Respiratory syncytial virus hospitalization and mortality: Systematic review and meta-analysis.
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DOI：
10.1002/ppul.23570
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发表时间：
2017-04
影响因子：
3.1
通讯作者：
Wegzyn C
中科院分区：
文献类型：
--
作者：
Stein RT;Bont LJ;Zar H;Polack FP;Park C;Claxton A;Borok G;Butylkova Y;Wegzyn C
背景：呼吸道合胞病毒（RSV）是全球主要的公共卫生负担。我们的目的是审查目前的文献中的严重RSV在全球儿童的发病率和死亡率。研究方法：对2000年以来发表的数据进行了系统性文献综述和Meta分析，报告了儿童中RSV引起的急性呼吸道感染（ARI）负担。主要结局为因重度RSV-ARI住院和死亡。结果：识别出5274篇参考文献。纳入了来自32个国家的55项研究。全球RSV-ARI住院估计数，每年每1，000名儿童报告（95%可信区间（CrI）为4.37（2.98，6.42）5岁以下儿童，19.19在1岁以下儿童中为15.04，24.48，在6个月以下儿童中为20.01（9.65，41.31），在1岁以下早产儿中为63.85（37.52，109.70）。每1,000名儿童报告的RSV‐ARI全球病死率估计值（95%Crl）在5岁以下儿童中为6.21（2.64，13.73），在1岁以下儿童中为6.60（1.85，16.93），在1岁以下早产儿中为1.04（0.17，12.06）。结论：相当大比例的RSV相关发病发生在生命的第一年，尤其是早产儿。这些数据证实了RSV疾病在住院原因中的重要性，并作为儿科死亡率的重要贡献者，并进一步证明胎龄是疾病严重程度的关键决定因素。病死率的一个重要局限性是缺乏非存活患者的个体患者特征。此外，病死率不能转化为基于人群的死亡率。小儿肺醇。2017;52：556-569.© 2016作者。儿科肺病学。出版社：Wiley Periodicals，Inc.
Background: Respiratory syncytial virus (RSV) is a major public health burden worldwide. We aimed to review the current literature on the incidence and mortality of severe RSV in children globally. Methods: Systematic literature review and meta‐analysis of published data from 2000 onwards, reporting on burden of acute respiratory infection (ARI) due to RSV in children. Main outcomes were hospitalization for severe RSV‐ARI and death. Results: Five thousand two hundred and seventy‐four references were identified. Fifty‐five studies were included from 32 countries. The global RSV‐ARI hospitalization estimates, reported per 1,000 children per year (95% Credible Interval (CrI), were 4.37 (2.98, 6.42) among children <5 years, 19.19 (15.04, 24.48) among children <1 year, 20.01 (9.65, 41.31) among children <6 months and 63.85 (37.52, 109.70) among premature children <1 year. The RSV‐ARI global case‐fatality estimates, reported per 1,000 children, (95% Crl) were 6.21 (2.64, 13.73) among children <5 years, 6.60 (1.85, 16.93) for children <1 year, and 1.04 (0.17, 12.06) among preterm children <1 year. Conclusions: A substantial proportion of RSV‐associated morbidity occurs in the first year of life, especially in children born prematurely. These data affirm the importance of RSV disease in the causation of hospitalization and as a significant contributor to pediatric mortality and further demonstrate gestational age as a critical determinant of disease severity. An important limitation of case‐fatality ratios is the absence of individual patient characteristics of non‐surviving patients. Moreover, case‐fatality ratios cannot be translated to population‐based mortality. Pediatr Pulmonol. 2017;52:556–569. © 2016 The Authors. Pediatric Pulmonology. Published by Wiley Periodicals, Inc.