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)诊治专家组. 慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017 年更新版). 国际呼吸杂志, 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, 姚婉贞, 常春. 慢性阻塞性肺疾病急性加重期住院患者死亡相关因素分析. 中国实用内科杂志, 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.	脱鸣富, 习静, 魏育芳, 等. 我国 AECOPD 患者继发肺部真菌感染危险因素的 Meta 分析. 中国医院药学杂志, 2020, 40(4): 412-418.
7.	Sundh J, Ekström 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.	刘开林. 慢性阻塞性肺病并发急性呼吸衰竭的危险因素分析. 内科, 2014, 9(3): 278-280,286.
10.	宣瑞萍, 查日田. COPD 并发呼吸衰竭的常见诱因及其死亡危险因素分析. 安徽医学, 2011, 32(3): 285-287.
11.	张恒. AECOPD 患者并发呼吸衰竭相关危险因素分析. 中国实用医药, 2018, 13(33): 1-3.
12.	张杰根, 郭青春, 华军霞, 等. 慢性阻塞性肺疾病致呼吸衰竭临界状态的相关危险因素分析及与预后的关系. 中国煤炭工业医学杂志, 2019, 22(4): 396-401.
13.	徐圣葆. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 中国医师进修杂志, 2010, 33(10): 4-6.
14.	成忠凤, 刘林. 慢性阻塞性肺病并发急性呼吸衰竭的危险因素分析. 世界最新医学信息文摘(连续型电子期刊), 2016, 16(72): 162-163.
15.	曹林发. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 江西医药, 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险因素分析. 中国医学前沿杂志(电子版), 2014, 6(7): 38-41.
17.	李毅云, 钱传云. 慢性阻塞性肺病致急性呼吸衰竭的相关危险及预后因素分析. 现代预防医学, 2013, 40(21): 4103-4105.
18.	王文欣, 周茄, 张宇, 等. 老年慢性阻塞性肺疾病合并呼吸衰竭危险因素分析. 中国现代医学杂志, 2018, 28(31): 113-117.
19.	王明将. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国继续医学教育, 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险因素分析. 临床医药文献电子杂志, 2017, 4(42): 8205-8207.
21.	陈红. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国实用医药, 2017, 12(30): 61-62.
22.	黎小惠. 慢性阻塞性肺疾病并发呼吸衰竭的危险因素分析. 国际医药卫生导报, 2013, 19(15): 2361-2363.
23.	钟晓芃. 关于慢性阻塞性肺疾病患者临界呼吸衰竭与呼吸衰竭关系的研究. 天津: 天津医科大学, 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 例呼吸系统重症患者血气分析及临床探讨. 重庆医学, 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)诊治专家组. 慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017 年更新版). 国际呼吸杂志, 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, 姚婉贞, 常春. 慢性阻塞性肺疾病急性加重期住院患者死亡相关因素分析. 中国实用内科杂志, 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. 脱鸣富, 习静, 魏育芳, 等. 我国 AECOPD 患者继发肺部真菌感染危险因素的 Meta 分析. 中国医院药学杂志, 2020, 40(4): 412-418.
7. Sundh J, Ekström 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. 刘开林. 慢性阻塞性肺病并发急性呼吸衰竭的危险因素分析. 内科, 2014, 9(3): 278-280,286.
10. 宣瑞萍, 查日田. COPD 并发呼吸衰竭的常见诱因及其死亡危险因素分析. 安徽医学, 2011, 32(3): 285-287.
11. 张恒. AECOPD 患者并发呼吸衰竭相关危险因素分析. 中国实用医药, 2018, 13(33): 1-3.
12. 张杰根, 郭青春, 华军霞, 等. 慢性阻塞性肺疾病致呼吸衰竭临界状态的相关危险因素分析及与预后的关系. 中国煤炭工业医学杂志, 2019, 22(4): 396-401.
13. 徐圣葆. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 中国医师进修杂志, 2010, 33(10): 4-6.
14. 成忠凤, 刘林. 慢性阻塞性肺病并发急性呼吸衰竭的危险因素分析. 世界最新医学信息文摘(连续型电子期刊), 2016, 16(72): 162-163.
15. 曹林发. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 江西医药, 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险因素分析. 中国医学前沿杂志(电子版), 2014, 6(7): 38-41.
17. 李毅云, 钱传云. 慢性阻塞性肺病致急性呼吸衰竭的相关危险及预后因素分析. 现代预防医学, 2013, 40(21): 4103-4105.
18. 王文欣, 周茄, 张宇, 等. 老年慢性阻塞性肺疾病合并呼吸衰竭危险因素分析. 中国现代医学杂志, 2018, 28(31): 113-117.
19. 王明将. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国继续医学教育, 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险因素分析. 临床医药文献电子杂志, 2017, 4(42): 8205-8207.
21. 陈红. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国实用医药, 2017, 12(30): 61-62.
22. 黎小惠. 慢性阻塞性肺疾病并发呼吸衰竭的危险因素分析. 国际医药卫生导报, 2013, 19(15): 2361-2363.
23. 钟晓芃. 关于慢性阻塞性肺疾病患者临界呼吸衰竭与呼吸衰竭关系的研究. 天津: 天津医科大学, 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 例呼吸系统重症患者血气分析及临床探讨. 重庆医学, 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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