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- Title
Is COPD associated with increased mortality and morbidity in hospitalized pneumonia? A systematic review and meta-analysis.
- Authors
Jiang, Hong‐Li; Chen, Hong‐Xuan; Liu, Wei; Fan, Tao; Liu, Guan‐Jian; Mao, Bing
- Abstract
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; I2 = 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; I2 = 80%). COPD was not associated with longer hospital stay ( MD, 0.11; 95% CI: −0.42 to 0.64; P = 0.68; I2 = 21%), more frequent ICU admission ( RR, 0.97; 95% CI: 0.70-1.35; P = 0.87; I2 = 65%), and more need for mechanical ventilation ( RR 0.91, 95% CI: 0.71-1.16; P = 0.44; I2 = 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.
- Subjects
OBSTRUCTIVE lung diseases; DEATH rate; PNEUMONIA; META-analysis; QUANTITATIVE research
- Publication
Respirology, 2015, Vol 20, Issue 7, p1046
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12597