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首页> 外文期刊>Respirology : >Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta-analysis
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Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta-analysis

机译：COPD会增加住院肺炎的死亡率和发病率吗？系统评价和荟萃分析

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This review aimed to investigate whether chronic obstructive pulmonary disease (COPD) is associated with increased mortality and morbidity in patients hospitalized with community-acquired pneumonia (CAP). EMBASE, Pub Med and Web of Science were searched for cohort studies and case-control studies investigating the impact of COPD on CAP. The primary outcome was all-cause mortality, and secondary outcomes included length of hospital stay, intensive care unit (ICU) admission and need for mechanical ventilation. Methodological quality was assessed using the Newcastle-Ottawa Scale. The Mantel-Haenszel method and inverse variance method were used to calculate pooled relative risks (RRs) and mean differences (MD), respectively. Eleven studies (nine cohort studies and two case-control studies), involving 257 958 patients, were included. The overall methodological quality was high. COPD was not associated with increased mortality in hospitalized CAP patients (RR, 1.20; 95% confidence interval (CI): 0.92-1.56; P = 0.19; I-2 = 55%) in cohort studies, and was associated with reduced mortality in case-control studies (RR, 0.82; 95% CI: 0.74-0.90; P < 0.0001; I-2 = 80%). COPD was not associated with longer hospital stay (MD, 0.11; 95% CI: -0.42 to 0.64; P = 0.68; I-2 = 21%), more frequent ICU admission (RR, 0.97; 95% CI: 0.70-1.35; P = 0.87; I-2 = 65%), and more need for mechanical ventilation (RR 0.91,95% CI: 0.71-1.16; P = 0.44; I-2 = 4%). The current available evidence indicates that COPD may not be associated with increased mortality and morbidity in patients hospitalized with CAP. This conclusion should be re-evaluated by prospective population-based cohort studies.
机译：这篇综述旨在调查在社区获得性肺炎（CAP）住院的患者中，慢性阻塞性肺疾病（COPD）是否与死亡率和发病率增加相关。搜寻EMBASE，Pub Med和Web of Science进行队列研究和病例对照研究，以调查COPD对CAP的影响。主要结局是全因死亡率，次要结局包括住院时间，重症监护病房（ICU）入院和需要机械通气。使用纽卡斯尔-渥太华量表对方法学质量进行评估。使用Mantel-Haenszel方法和逆方差方法分别计算合并的相对风险（RRs）和平均差异（MD）。包括11项研究（9项队列研究和2项病例对照研究），涉及257 958例患者。总体方法学质量很高。在队列研究中，COPD与住院CAP患者的死亡率增加无关（RR，1.20; 95％置信区间（CI）：0.92-1.56; P = 0.19; I-2 = 55％），并且与降低COPD死亡率相关。病例对照研究（RR，0.82; 95％CI：0.74-0.90; P <0.0001; I-2 = 80％）。 COPD与住院时间较长无关（MD，0.11; 95％CI：-0.42至0.64; P = 0.68; I-2 = 21％），更频繁的ICU入院率（RR，0.97; 95％CI：0.70-1.35 ; P = 0.87; I-2 = 65％），并且对机械通风的需求更高（RR 0.91,95％CI：0.71-1.16; P = 0.44; I-2 = 4％）。目前可获得的证据表明，COPD可能与CAP住院患者的死亡率和发病率增加无关。该结论应通过基于人群的前瞻性队列研究进行重新评估。

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