Incidence and Mortality of Acute Respiratory Distress Syndrome in Patients With Burns: A Systematic Review and Meta-Analysis.
Incidence and Mortality of Acute Respiratory Distress Syndrome in Patients With Burns: A Systematic Review and Meta-Analysis.
复制标题
烧伤患者急性呼吸窘迫综合征的发病率和死亡率：系统评价和荟萃分析
DOI：
10.3389/fmed.2021.709642
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发表时间：
2021
影响因子：
3.9
通讯作者：
Xia Z
中科院分区：
文献类型：
--
作者：
Wang B;Chenru W;Jiang Y;Hu L;Fang H;Zhu F;Yu Q;Zhu B;Wu G;Sun Y;Xia Z
目的：我们进行了系统回顾和荟萃分析，以全面估计烧伤患者整体和亚组中急性呼吸窘迫综合征（ARDS）的发病率和死亡率。数据来源：Pubmed、Embase、Cochrane 图书馆、CINAHL 数据库和中国国家知识基础设施数据库的检索截止日期为 2021 年 9 月 1 日。 研究选择：选择报告烧伤患者 ARDS 发生率或死亡率研究数据的文章。数据提取：两名研究者独立筛选文献、提取数据并评估质量。我们使用随机效应模型对烧伤患者 ARDS 的发生率和死亡率进行了荟萃分析，根据研究类型、纳入（机械通气、最小烧伤面积）、ARDS 定义、地理位置、平均年龄、烧伤严重程度和吸入性损伤进行亚组分析。主要结局是烧伤患者 ARDS 的发生率和死亡率，次要结局是不同亚组的发生率。数据综合：烧伤患者 ARDS 发生率和死亡率的汇总加权估计值为 0.24 [95% 置信区间 (CI)0.2–0.28] 和 0.31 [95% CI 0.18–0.44]。机械通气患者（发生率=0.37）、柏林定义诊断（发生率=0.35）、吸入性损伤比例超过50%（发生率=0.41）的ARDS发生率明显高于烧伤患者。与来自亚洲/非洲国家（0.28 vs. 0.25）和无吸入性损伤（0.41 vs. 0.24）的烧伤患者相比，来自西方国家且有吸入性损伤的烧伤患者ARDS发生率明显更高。结论：本系统回顾和荟萃分析显示，烧伤患者ARDS的发生率为24%，死亡率高达31%。发生率与机械通气、部位、吸入性损伤有关。西方国家烧伤并伴有吸入性损伤的患者发生率明显高于亚非国家且无吸入性损伤的患者。系统审查注册：标识符：CRD42021144888。
Objective: We conducted a systematic review and meta-analysis to comprehensively estimate the incidence and mortality of acute respiratory distress syndrome (ARDS) in overall and subgroups of patients with burns. Data sources: Pubmed, Embase, the Cochrane Library, CINAHL databases, and China National Knowledge Infrastructure database were searched until September 1, 2021. Study selection: Articles that report study data on incidence or mortality of ARDS in patients with burns were selected. Data extraction: Two researchers independently screened the literature, extracted data, and assessed the quality. We performed a meta-analysis of the incidence and mortality of ARDS in patients with burns using a random effects model, which made subgroup analysis according to the study type, inclusion (mechanical ventilation, minimal burn surface), definitions of ARDS, geographic location, mean age, burn severity, and inhalation injury. Primary outcomes were the incidence and mortality of burns patients with ARDS, and secondary outcomes were incidence for different subgroups. Data synthesis: Pooled weighted estimate of the incidence and mortality of ARDS in patients with burns was 0.24 [95% confidence interval (CI)0.2–0.28] and 0.31 [95% CI 0.18−0.44]. Incidences of ARDS were obviously higher in patients on mechanical ventilation (incidence = 0.37), diagnosed by Berlin definition (incidence = 0.35), and with over 50% inhalation injury proportion (incidence = 0.41) than in overall patients with burns. Patients with burns who came from western countries and with inhalation injury have a significantly higher incidence of ARDS compared with those who came from Asian/African countries (0.28 vs. 0.25) and without inhalation injury (0.41 vs. 0.24). Conclusion: This systematic review and meta-analysis revealed that the incidence of ARDS in patients with burns is 24% and that mortality is as high as 31%. The incidence rates are related to mechanical ventilation, location, and inhalation injury. The patients with burns from western countries and with inhalation injury have a significantly higher incidence than patients from Asian/African countries and without inhalation injury. Systematic Review Registration: identifier: CRD42021144888.