Meta-analysis on risk factors for secondary respiratory failure in patients with chronic obstructive pulmonary disease_West China Medical Journal

Authors：

CHEN Jun , PENG Ya , MAO Jinjuan , WANG Gangsheng ,  SU Chunyan

Department of Respiratory Medicine, Edong Medical Group City Center Hospital, Hubei Institute of Technology Affiliated Hospital, Huangshi, Hubei 435000, P. R. China;

Corresponding?author：

SU Chunyan, Email: 403970156@qq.com

Keywords：

Chronic obstructive pulmonary diseases; Respiratory failure; Risk factors; Meta-analysis

DOI：

10.7507/1002-0179.202012001

Video：

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Objective To systematically evaluate the risk factors for secondary respiratory failure (RF) on chronic obstructive pulmonary disease (COPD), so as to provide evidence for formulating prevention and control strategies. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP databases and SinoMed were searched for articles published from the dates of establishment of databases to August 2021. To collect the relevant case-control studies or cohort studies on the risk factors of secondary RF in patients with COPD. The patients were divided into two groups, RF group and non RF group. Meta-analysis was carried out with RevMan 5.3 software after selecting literature, extracting data and evaluating quality according to inclusion and exclusion criteria. Results A total of 16 case-control studies involving 2 417 patients were included. There were 856 cases in RF group and 1 561 cases in non RF group. The results of meta-analysis showed that age [mean difference (MD)=0.58 years, 95% confidence interval (CI) (0.18, 0.97) years, P=0.004], number of acute attacks per year [MD=2.68 times, 95%CI (2.58, 2.78) times, P<0.001], number of acute attacks per year over 3 [odds ratio (OR)=3.37, 95%CI (2.40, 4.73), P<0.001], serum albumin level [MD=?2.93 g/L, 95%CI (?3.92, ?1.94), P<0.001], serum uric acid [MD= ?59.91 mmol/L, 95%CI (?66.57, ?53.25) mmol/L, P<0.001], nosocomial infection [OR=4.53, 95%CI (3.44, 5.98), P<0.001], no-inhaled glucocorticoid [OR=3.63, 95%CI (2.95, 4.48), P<0.001], acid-base imbalance [OR=13.22, 95%CI (10.14, 17.23), P<0.001], COPD very serious [OR=1.82, 95%CI (1.50, 2.21), P<0.001], cardiovascular disease [OR=2.73, 95%CI (1.99, 3.74), P<0.001], kidney disease [OR=3.62, 95%CI (2.67, 4.90), P<0.001] were risk factors for RF in COPD. Sensitivity analysis showed that the results of meta-analysis were stable. Conclusion According to the results of meta-analysis, the risk factors of secondary RF in COPD can be identified in time and preventive measures can be taken to effectively reduce the incidence of aspiration failure and improve the prognosis and outcome of patients.

Citation： CHEN Jun, PENG Ya, MAO Jinjuan, WANG Gangsheng, SU Chunyan. Meta-analysis on risk factors for secondary respiratory failure in patients with chronic obstructive pulmonary disease. West China Medical Journal, 2021, 36(11): 1563-1569. doi: 10.7507/1002-0179.202012001 Copy

1.	慢性阻塞性肺疾病急性加重(AECOPD)診治專家組. 慢性阻塞性肺疾病急性加重(AECOPD)診治中國專家共識(2017 年更新版). 國際呼吸雜志, 2017, 37(14): 1041-1057.
2.	Chen CW, Chen YY, Lu CL, et al. Severe hypoalbuminemia is a strong independent risk factors for acute respiratory failure in COPD: a nationwide cohort study. Int J Chron Obstruct Pulmon Dis, 2015, 10: 1147-1154.
3.	Titlestad IL, Lassen AT, Vestbo J. Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure. Int J Chron Obstruct Pulmon Dis, 2013, 8: 215-219.
4.	方天舒, 姚婉貞, 常春. 慢性阻塞性肺疾病急性加重期住院患者死亡相關因素分析. 中國實用內科雜志, 2010, 30(11): 1010-1012.
5.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
6.	脫鳴富, 習靜, 魏育芳, 等. 我國 AECOPD 患者繼發肺部真菌感染危險因素的 Meta 分析. 中國醫院藥學雜志, 2020, 40(4): 412-418.
7.	Sundh J, Ekstr?m M. Risk factors for developing hypoxic respiratory failure in COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2095-2100.
8.	Almagro P, Barreiro B, Ochoa de Echaguen A, et al. Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration, 2006, 73(3): 311-317.
9.	劉開林. 慢性阻塞性肺病并發急性呼吸衰竭的危險因素分析. 內科, 2014, 9(3): 278-280,286.
10.	宣瑞萍, 查日田. COPD 并發呼吸衰竭的常見誘因及其死亡危險因素分析. 安徽醫學, 2011, 32(3): 285-287.
11.	張恒. AECOPD 患者并發呼吸衰竭相關危險因素分析. 中國實用醫藥, 2018, 13(33): 1-3.
12.	張杰根, 郭青春, 華軍霞, 等. 慢性阻塞性肺疾病致呼吸衰竭臨界狀態的相關危險因素分析及與預后的關系. 中國煤炭工業醫學雜志, 2019, 22(4): 396-401.
13.	徐圣葆. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 中國醫師進修雜志, 2010, 33(10): 4-6.
14.	成忠鳳, 劉林. 慢性阻塞性肺病并發急性呼吸衰竭的危險因素分析. 世界最新醫學信息文摘(連續型電子期刊), 2016, 16(72): 162-163.
15.	曹林發. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 江西醫藥, 2010, 45(2): 129-131.
16.	李春. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國醫學前沿雜志(電子版), 2014, 6(7): 38-41.
17.	李毅云, 錢傳云. 慢性阻塞性肺病致急性呼吸衰竭的相關危險及預后因素分析. 現代預防醫學, 2013, 40(21): 4103-4105.
18.	王文欣, 周茄, 張宇, 等. 老年慢性阻塞性肺疾病合并呼吸衰竭危險因素分析. 中國現代醫學雜志, 2018, 28(31): 113-117.
19.	王明將. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國繼續醫學教育, 2017, 9(4): 127-128.
20.	石康. 慢性阻塞性肺疾病(COPD)致急性呼吸衰竭的危險因素分析. 臨床醫藥文獻電子雜志, 2017, 4(42): 8205-8207.
21.	陳紅. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國實用醫藥, 2017, 12(30): 61-62.
22.	黎小惠. 慢性阻塞性肺疾病并發呼吸衰竭的危險因素分析. 國際醫藥衛生導報, 2013, 19(15): 2361-2363.
23.	鐘曉芃. 關于慢性阻塞性肺疾病患者臨界呼吸衰竭與呼吸衰竭關系的研究. 天津: 天津醫科大學, 2005.
24.	Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
25.	Sehgal IS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med, 2017, 23(2): 139-148.
26.	Yamaya M, Usami O, Nakayama S, et al. Malnutrition, airflow limitation and severe emphysema are risks for exacerbation of chronic obstructive pulmonary disease in Japanese subjects: a retrospective single-center study. Int J Chron Obstruct Pulmon Dis, 2020, 15: 857-868.
27.	周立. 109 例呼吸系統重癥患者血氣分析及臨床探討. 重慶醫學, 2007, 36(10): 912-913.
28.	Chao TF, Liu CJ, Tuan TC, et al. Risk and prediction of sudden cardiac death and ventricular arrhythmias for patients with atrial fibrillation - a nationwide cohort study. Sci Rep, 2017, 7: 46445.

1. 慢性阻塞性肺疾病急性加重(AECOPD)診治專家組. 慢性阻塞性肺疾病急性加重(AECOPD)診治中國專家共識(2017 年更新版). 國際呼吸雜志, 2017, 37(14): 1041-1057.
2. Chen CW, Chen YY, Lu CL, et al. Severe hypoalbuminemia is a strong independent risk factors for acute respiratory failure in COPD: a nationwide cohort study. Int J Chron Obstruct Pulmon Dis, 2015, 10: 1147-1154.
3. Titlestad IL, Lassen AT, Vestbo J. Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure. Int J Chron Obstruct Pulmon Dis, 2013, 8: 215-219.
4. 方天舒, 姚婉貞, 常春. 慢性阻塞性肺疾病急性加重期住院患者死亡相關因素分析. 中國實用內科雜志, 2010, 30(11): 1010-1012.
5. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
6. 脫鳴富, 習靜, 魏育芳, 等. 我國 AECOPD 患者繼發肺部真菌感染危險因素的 Meta 分析. 中國醫院藥學雜志, 2020, 40(4): 412-418.
7. Sundh J, Ekstr?m M. Risk factors for developing hypoxic respiratory failure in COPD. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2095-2100.
8. Almagro P, Barreiro B, Ochoa de Echaguen A, et al. Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration, 2006, 73(3): 311-317.
9. 劉開林. 慢性阻塞性肺病并發急性呼吸衰竭的危險因素分析. 內科, 2014, 9(3): 278-280,286.
10. 宣瑞萍, 查日田. COPD 并發呼吸衰竭的常見誘因及其死亡危險因素分析. 安徽醫學, 2011, 32(3): 285-287.
11. 張恒. AECOPD 患者并發呼吸衰竭相關危險因素分析. 中國實用醫藥, 2018, 13(33): 1-3.
12. 張杰根, 郭青春, 華軍霞, 等. 慢性阻塞性肺疾病致呼吸衰竭臨界狀態的相關危險因素分析及與預后的關系. 中國煤炭工業醫學雜志, 2019, 22(4): 396-401.
13. 徐圣葆. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 中國醫師進修雜志, 2010, 33(10): 4-6.
14. 成忠鳳, 劉林. 慢性阻塞性肺病并發急性呼吸衰竭的危險因素分析. 世界最新醫學信息文摘(連續型電子期刊), 2016, 16(72): 162-163.
15. 曹林發. 慢性阻塞性肺疾病并發呼吸衰竭相關危險因素分析. 江西醫藥, 2010, 45(2): 129-131.
16. 李春. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國醫學前沿雜志(電子版), 2014, 6(7): 38-41.
17. 李毅云, 錢傳云. 慢性阻塞性肺病致急性呼吸衰竭的相關危險及預后因素分析. 現代預防醫學, 2013, 40(21): 4103-4105.
18. 王文欣, 周茄, 張宇, 等. 老年慢性阻塞性肺疾病合并呼吸衰竭危險因素分析. 中國現代醫學雜志, 2018, 28(31): 113-117.
19. 王明將. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國繼續醫學教育, 2017, 9(4): 127-128.
20. 石康. 慢性阻塞性肺疾病(COPD)致急性呼吸衰竭的危險因素分析. 臨床醫藥文獻電子雜志, 2017, 4(42): 8205-8207.
21. 陳紅. 慢性阻塞性肺疾病致急性呼吸衰竭的危險因素分析. 中國實用醫藥, 2017, 12(30): 61-62.
22. 黎小惠. 慢性阻塞性肺疾病并發呼吸衰竭的危險因素分析. 國際醫藥衛生導報, 2013, 19(15): 2361-2363.
23. 鐘曉芃. 關于慢性阻塞性肺疾病患者臨界呼吸衰竭與呼吸衰竭關系的研究. 天津: 天津醫科大學, 2005.
24. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
25. Sehgal IS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med, 2017, 23(2): 139-148.
26. Yamaya M, Usami O, Nakayama S, et al. Malnutrition, airflow limitation and severe emphysema are risks for exacerbation of chronic obstructive pulmonary disease in Japanese subjects: a retrospective single-center study. Int J Chron Obstruct Pulmon Dis, 2020, 15: 857-868.
27. 周立. 109 例呼吸系統重癥患者血氣分析及臨床探討. 重慶醫學, 2007, 36(10): 912-913.
28. Chao TF, Liu CJ, Tuan TC, et al. Risk and prediction of sudden cardiac death and ventricular arrhythmias for patients with atrial fibrillation - a nationwide cohort study. Sci Rep, 2017, 7: 46445.

West China Medical Journal

Meta-analysis on risk factors for secondary respiratory failure in patients with chronic obstructive pulmonary disease

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