Prevalence, Risk Factors, and Outcomes of Adult Interstitial Lung Abnormalities: A Systematic Review and Meta-Analysis.
Prevalence, Risk Factors, and Outcomes of Adult Interstitial Lung Abnormalities: A Systematic Review and Meta-Analysis.
复制标题
成人间质性肺异常的患病率、危险因素和结果：系统回顾和荟萃分析。
DOI：
10.1164/rccm.202302-0271oc
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发表时间：
2023
影响因子：
24.7
通讯作者：
Johannson,KerriA
中科院分区：
文献类型：
--
作者：
Grant-Orser,Amanda;Min,Bohyung;Elmrayed,Seham;Podolanczuk,AnnaJ;Johannson,KerriA
依据：胸部计算机断层扫描检测到的偶发性肺实质异常称为间质性肺异常（ILA）。ILA可能代表早期间质性肺病（ILD），并与进行性纤维化和死亡率风险增加相关。ILA的患病率是未知的，异质性研究population.Objectives：估计汇总患病率ILA在肺癌筛查，一般人群为基础的，并在危险的家族性队列使用荟萃分析;确定变量与ILA的风险;和ILA相关mortality.Methods：研究方案注册PROSPERO（CRD 42022373203），并遵循流行病学建议的观察性研究荟萃分析。在Embase和Medline上检索相关研究。筛选研究标题并审查摘要的全文合格性。随机效应模型用于汇总特定亚组和ILA相关死亡风险的患病率估计值。根据年龄、性别和FVC估计ILA的风险。质量评估是使用一个适应评估工具进行的患病率Studies. Measures和主要结果：检索确定了9,536项研究，包括22个，包括88,325名参与者。肺癌筛查中汇总的ILA患病率为7%（95%置信区间[CI]，0.01-0.13），一般人群为7%（95% CI，0.04-0.10），家族性队列为26%（95% CI，0.20-0.32）。ILA患者的合并死亡风险增加（比值比，3.56; 95%CI，2.19-5.81）。年龄较大、男性和较低的FVC%与ILA.Conclusions的更大几率相关：接受非ILD适应症影像学检查的人群显示ILA患病率较高。需要对ILA进行标准化报告和随访，包括定义进展为ILD的风险最大的患者。
Rationale:Incidental parenchymal abnormalities detected on chest computed tomography scans are termed interstitial lung abnormalities (ILAs). ILAs may represent early interstitial lung disease (ILD) and are associated with an increased risk of progressive fibrosis and mortality. The prevalence of ILAs is unknown, with heterogeneity across study populations.Objectives:Estimate the pooled prevalence of ILAs in lung cancer screening, general population-based, and at-risk familial cohorts using meta-analysis; identify variables associated with ILA risk; and characterize ILA-associated mortality.Methods:The study protocol was registered on PROSPERO (CRD42022373203), and Meta-analyses of Observational Studies in Epidemiology recommendations were followed. Relevant studies were searched on Embase and Medline. Study titles were screened and abstracts reviewed for full-text eligibility. Random effect models were used to pool prevalence estimates for specified subgroups and ILA-associated mortality risk. Risk of ILAs was estimated based on age, sex, and FVC. Quality assessment was conducted using an adapted Assessment Tool for Prevalence Studies.Measurements and Main Results:The search identified 9,536 studies, with 22 included, comprising 88,325 participants. The pooled ILA prevalence was 7% (95% confidence interval [CI], 0.01–0.13) in lung cancer screening, 7% (95% CI, 0.04–0.10) in general population, and 26% (95% CI, 0.20–0.32) in familial cohorts. Pooled mortality risk was increased in those with ILAs (odds ratio, 3.56; 95% CI, 2.19–5.81). Older age, male sex, and lower FVC% were associated with greater odds of ILA.Conclusions:Populations undergoing imaging for non-ILD indications demonstrate high ILA prevalence. Standardized reporting and follow-up of ILAs is needed, including defining those at greatest risk of progression to ILD.