脓毒症患者急性呼吸窘迫综合征的合并症相关危险因素:系统回顾和荟萃分析

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Xin Lin, Yang Liu, Li Kong, Tejin Ba, Bagenna Bao, Shuanglin Zhang, Weihong Liu
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引用次数: 0

摘要

背景:急性呼吸窘迫综合征(ARDS)在脓毒症的治疗中提出了重大挑战,各种合并症可能影响其发展。了解这些合并症的影响对改善患者预后至关重要。目的:本荟萃分析旨在探讨脓毒症患者各种合并症与ARDS发展之间的关系,以提高对该疾病的认识和管理。材料和方法:本研究纳入8项研究的成人脓毒症患者,共16,964名参与者。使用纽卡斯尔-渥太华量表(NOS)评估偏倚风险,并使用随机效应模型计算合并优势比(ORs)进行数据分析和报告。异质性和发表偏倚分别采用I2统计量和Doi图与Luis Furuya-Kanamori (LFK)指数进行评估。结果:慢性阻塞性肺疾病与ARDS风险增加显著相关(OR: 1.43, 95%可信区间(95% CI): 1.02-2.01)。其他合共病:糖尿病(DM) (OR: 0.88, 95% CI: 0.69-1.11)、高血压(HTN) (OR: 0.86, 95% CI: 0.56 - 1.34)、冠状动脉疾病(CAD) (OR: 0.95, 95% CI: 0.86-1.06)、充血性心力衰竭(CHF) (OR: 1.08, 95% CI: 0.61- 1.90)、慢性肾脏疾病(CKD) (OR: 0.89, 95% CI: 0.65-1.22)、慢性肝病(CLD) (OR: 1.13, 95% CI: 0.61-2.09)和癌症(OR: 0.90, 95% CI: 0.59-1.35)。另外的分析显示了中度到高度的异质性和一些发表偏倚的证据。结论:慢性阻塞性肺疾病是脓毒症患者发生ARDS的重要危险因素,需要加强对该组患者的监测和管理。脓毒症的发生机制和其他潜在的ARDS危险因素有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comorbidity-related risk factors for acute respiratory distress syndrome in sepsis patients: A systematic review and meta-analysis.

Background: Acute respiratory distress syndrome (ARDS) presents a significant challenge in the management of sepsis, with various comorbidities potentially influencing its development. Understanding the impact of these comorbidities is crucial for improving patient outcomes.

Objectives: This meta-analysis was conducted to investigate the relationship between various comorbidities and the development of ARDS in patients with sepsis, with the aim of improving understanding and management of this condition.

Material and methods: The study included adult sepsis patients from 8 studies, totaling 16,964 participants. Risk of bias was assessed using the Newcastle-Ottawa scale (NOS), and the data analysis was performed and reported as pooled odds ratios (ORs) computed using a random-effects model. Heterogeneity and publication bias were assessed using the I2 statistic and Doi plots with the Luis Furuya-Kanamori (LFK) index, respectively.

Results: Chronic obstructive pulmonary disease was significantly associated with an increased risk of ARDS (OR: 1.43, 95% confidence interval (95% CI): 1.02-2.01). Other comorbidities showed no significant associations: diabetes mellitus (DM) (OR: 0.88, 95% CI: 0.69-1.11), hypertension (HTN) (OR: 0.86, 95% CI: 0.56 to 1.34), coronary artery disease (CAD) (OR: 0.95, 95% CI: 0.86-1.06), congestive heart failure (CHF) (OR: 1.08, 95% CI: 0.61 to 1.90), chronic kidney disease (CKD) (OR: 0.89, 95% CI: 0.65-1.22), chronic liver disease (CLD) (OR: 1.13, 95% CI: 0.61-2.09), and cancer (OR: 0.90, 95% CI: 0.59-1.35). Additional analyses indicated moderate-to-high heterogeneity and some evidence of publication bias.

Conclusion: Chronic obstructive pulmonary disease is a notable risk factor for ARDS in sepsis patients, suggesting the need for enhanced surveillance and management in this group. Further research is necessary to understand the mechanisms and explore other potential ARDS risk factors in sepsis.

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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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