COPD-related morbidity and mortality after smoking cessation: status of the evidence
COPD-related morbidity and mortality after smoking cessation: status of the evidence
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DOI：
10.1183/09031936.00160007
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发表时间：
2008-10-01
影响因子：
24.3
通讯作者：
Vestbo, J.
中科院分区：
文献类型：
--
作者：
Godtfredsen, N. S.;Lam, T. H.;Vestbo, J.
戒烟对中重度慢性阻塞性肺疾病（COPD）患者的发病率和死亡率结局的益处的证据基础是有限的。对医学数据库进行了系统性文献检索，直至2006年3月，随后直至2007年9月1日。研究结果为COPD患者戒烟后的COPD相关发病率和死亡率（包括全因死亡率）。对于这两种结局，只有少数研究纳入了重度COPD患者。大多数研究报告了戒烟与继续吸烟相比的有益效果，而少数研究发现没有改善。方法学问题，包括研究规模小，数据质量差，反向因果关系的可能性和死亡原因的不完全确定，限制了一些研究的解释，证据作为一个整体支持的结论是，即使在严重的慢性阻塞性肺疾病，戒烟减缓肺功能下降的加速速度，并提高生存率与继续吸烟。
The evidence base for the benefit of quitting smoking as regards morbidity and mortality outcomes in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) is limited.The present article is a review of the existing literature. A systematic literature search in medical databases was performed until March 2006, and subsequently until September 1, 2007. The outcomes examined were COPD-related morbidity and mortality (including all-cause mortality) in COPD patients in connection with smoking cessation.A total of 21 and 27 published articles on morbidity and mortality, respectively, were identified and reviewed. For both outcomes, only a few of the studies included patients with severe COPD. Most of the studies reported a beneficial effect of smoking cessation compared with continued smoking, whereas a few found no improvement. Methodological problems, including small study sizes, poor data quality, possibility of reverse causality and incomplete ascertainment of cause of death, limit interpretation of some of the studies.The evidence as a whole supports the conclusion that, even in severe chronic obstructive pulmonary disease, smoking cessation slows the accelerated rate of lung function decline and improves survival compared with continued smoking.