Long term sequelae from childhood pneumonia; systematic review and meta-analysis.
Long term sequelae from childhood pneumonia; systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0031239
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Campbell H
中科院分区：
文献类型：
--
作者：
Edmond K;Scott S;Korczak V;Ward C;Sanderson C;Theodoratou E;Clark A;Griffiths U;Rudan I;Campbell H
儿童肺炎的长期后遗症的风险尚未得到系统评估。这项研究的目的是：(I)估计五岁以下儿童肺炎后呼吸道后遗症的风险；(Ii)估计不同类型呼吸道后遗症的分布；以及(Iii)比较住院状况和病原体的后遗症风险。我们系统地回顾了1970年至2011年发表的论文。标准的全球疾病负担类别(限制性肺病、阻塞性肺病、支气管扩张症)被标记为主要后遗症。轻微的后遗症(慢性支气管炎、哮喘、其他肺功能异常、其他呼吸系统疾病)和多种损害也包括在内。13篇论文入选。综合采用随机效应Meta分析和Meta回归。在非住院儿童中，至少有一个重大后遗症的风险为5.5%(95%可信区间[95%CI]2.8-8.3%)，在住院儿童中为13.6%[6.2-21.1%]。腺病毒肺炎与最高的后遗症风险相关(54.8%[39.2-70.5%])，但未分离病原体的住院儿童也有高风险(17.6%[10.9-24.3%])。最常见的主要后遗症是限制性肺部疾病(5.4%[2.5-10.2%])。在最终模型中，潜在的混杂因素，如失去随访时间和感染时的中位年龄，与后遗症风险无关。所有由卫生专业人员诊断为肺炎的儿童都应被视为有长期后遗症的风险。对儿童肺炎干预措施的评估应包括对长期呼吸道后遗症的潜在影响。
The risks of long term sequelae from childhood pneumonia have not been systematically assessed. The aims of this study were to: (i) estimate the risks of respiratory sequelae after pneumonia in children under five years; (ii) estimate the distribution of the different types of respiratory sequelae; and (iii) compare sequelae risk by hospitalisation status and pathogen. We systematically reviewed published papers from 1970 to 2011. Standard global burden of disease categories (restrictive lung disease, obstructive lung disease, bronchiectasis) were labelled as major sequelae. ‘Minor’ sequelae (chronic bronchitis, asthma, other abnormal pulmonary function, other respiratory disease), and multiple impairments were also included. Thirteen papers were selected for inclusion. Synthesis was by random effects meta-analysis and meta-regression. Risk of at least one major sequelae was 5.5% (95% confidence interval [95% CI] 2.8–8.3%) in non hospitalised children and 13.6% [6.2–21.1%]) in hospitalised children. Adenovirus pneumonia was associated with the highest sequelae risk (54.8% [39.2–70.5%]) but children hospitalised with no pathogen isolated also had high risk (17.6% [10.9–24.3%]). The most common type of major sequela was restrictive lung disease (5.4% [2.5–10.2%]) . Potential confounders such as loss to follow up and median age at infection were not associated with sequelae risk in the final models. All children with pneumonia diagnosed by a health professional should be considered at risk of long term sequelae. Evaluation of childhood pneumonia interventions should include potential impact on long term respiratory sequelae.
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DOI：
10.1001/archpedi.1971.02110050056004
发表时间：
1971-01-01
影响因子：
--
作者：
CERUTI, E;CONTRERAS, J;NEIRA, M
通讯作者：
NEIRA, M
影响因子：
--
作者：
Piippo-Savolainen, E;Remes, S;Korppi, M
通讯作者：
Korppi, M
影响因子：
4.4
作者：
McEachern, R;Campbell, GD
通讯作者：
Campbell, GD
影响因子：
15.8
作者：
Liberati A;Altman DG;Tetzlaff J;Mulrow C;Gøtzsche PC;Ioannidis JP;Clarke M;Devereaux PJ;Kleijnen J;Moher D
通讯作者：
Moher D
影响因子：
158.5
作者：
Johnston, IDA;Strachan, DP;Anderson, HR
通讯作者：
Anderson, HR