Risk of aspiration pneumonia and hospital mortality in Parkinson disease: A systematic review and meta-analysis

IF 4.5 2区 医学 Q1 CLINICAL NEUROLOGY
Wei Yu Chua, Jia Dong James Wang, Claire Kar Min Chan, Ling-Ling Chan, Eng-King Tan
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Abstract

Background and Purpose

This study was undertaken to conduct a meta-analysis on the prevalence of aspiration pneumonia (AP) and hospital mortality in Parkinson disease (PD) as well as the risk of AP in PD patients compared to controls.

Methods

We searched MEDLINE and Embase from inception to 19 March 2024 to identify cross-sectional, cohort, and case–control studies comparing the frequency of AP and hospital mortality in PD patients. We computed risk ratios (RRs) with accompanying 95% confidence intervals (CIs) for each study and pooled the results using a random-effects meta-analysis.

Results

A total of 781 studies were initially screened, and 13 studies involving 541,785,587 patients were included. Patients with PD had >3 times higher risk of AP compared to controls (RR = 3.30, 95% CI = 1.82–6.00, p < 0.0001). This increased risk was similar in both cohort studies (RR = 3.01, 95% CI = 1.10–8.24, p = 0.03) and case–control studies (RR = 3.86, 95% CI = 3.84–3.87, p < 0.00001). The prevalence of AP in 12 studies was 2.74% (95% CI = 1.69–4.41), and hospital mortality was 10% in six studies (10.0%, 95% CI = 5.32–18.0). Prevalence of AP was higher in studies with smaller sample size (5.26%, 95% CI = 3.08–8.83 vs. 2.06%, 95% CI = 1.19–3.55, p = 0.02).

Conclusions

Our meta-analysis showed that patients with PD had >3 times higher risk of AP, with an average 2.74% prevalence and 10.0% hospital mortality. Early recognition and treatment of AP in PD patients will help reduce morbidity and mortality. A multidisciplinary holistic approach is needed to address the multifactorial causes of AP.

Abstract Image

帕金森病患者吸入性肺炎的风险与住院死亡率:系统回顾和荟萃分析。
背景和目的:本研究旨在对帕金森病(PD)吸入性肺炎(AP)的发病率和住院死亡率以及帕金森病患者与对照组相比发生 AP 的风险进行荟萃分析:我们检索了从开始到 2024 年 3 月 19 日的 MEDLINE 和 Embase,以确定比较帕金森病患者吸入性肺炎发生率和住院死亡率的横断面、队列和病例对照研究。我们计算了每项研究的风险比(RRs)及95%置信区间(CIs),并采用随机效应荟萃分析对结果进行了汇总:初步筛选了781项研究,共纳入13项研究,涉及54178587名患者。与对照组相比,PD 患者罹患 AP 的风险要高出 3 倍以上(RR = 3.30,95% CI = 1.82-6.00,P我们的荟萃分析表明,帕金森病患者罹患 AP 的风险是对照组的 3 倍以上,平均发病率为 2.74%,住院死亡率为 10.0%。早期识别和治疗帕金森病患者的 AP 将有助于降低发病率和死亡率。需要采用多学科综合方法来解决导致 AP 的多因素原因。
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来源期刊
European Journal of Neurology
European Journal of Neurology 医学-临床神经学
CiteScore
9.70
自引率
2.00%
发文量
418
审稿时长
1 months
期刊介绍: The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).
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