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Predictors of mortality in chronic obstructive pulmonary disease: a systematic review and meta-analysis.
- Source :
- BMC Pulmonary Medicine; 4/4/2022, Vol. 22 Issue 1, p1-13, 13p
- Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Better insight in patients' prognosis can help physicians to timely initiate advance care planning (ACP) discussions with patients with chronic obstructive pulmonary disease (COPD). We aimed to identify predictors of mortality.<bold>Methods: </bold>We systematically searched databases Embase, PubMed, MEDLINE, Web of Science, and Cochrane Central in April 2020. Papers reporting on predictors or prognostic models for mortality at 3 months and up to 24 months were assessed on risk-of-bias. We performed a meta-analysis with a fixed or random-effects model, and evaluated the discriminative ability of multivariable prognostic models.<bold>Results: </bold>We included 42 studies (49-418,251 patients); 18 studies were included in the meta-analysis. Significant predictors of mortality within 3-24 months in the random-effects model were: previous hospitalization for acute exacerbation (hazard ratio [HR] 1.97; 95% confidence interval [CI] 1.32-2.95), hospital readmission within 30 days (HR 5.01; 95% CI 2.16-11.63), cardiovascular comorbidity (HR 1.89; 95% CI 1.25-2.87), age (HR 1.48; 95% CI 1.38-1.59), male sex (HR 1.68; 95% CI 1.38-1.59), and long-term oxygen therapy (HR 1.74; 95% CI 1.10-2.73). Nineteen previously developed multicomponent prognostic models, as examined in 11 studies, mostly had moderate discriminate ability.<bold>Conclusion: </bold>Identified predictors of mortality may aid physicians in selecting COPD patients who may benefit from ACP. However, better discriminative ability of prognostic models or development of a new prognostic model is needed for further large-scale implementation.<bold>Registration: </bold>PROSPERO (CRD42016038494), https://www.crd.york.ac.uk/prospero/ . [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC obstructive pulmonary disease
ADVANCE directives (Medical care)
PROGNOSTIC models
PATIENT readmissions
OXYGEN therapy
OBSTRUCTIVE lung disease treatment
RESEARCH
META-analysis
RESEARCH methodology
SYSTEMATIC reviews
PROGNOSIS
EVALUATION research
COMPARATIVE studies
HOSPITAL care
RESEARCH funding
PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 14712466
- Volume :
- 22
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Pulmonary Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 156111487
- Full Text :
- https://doi.org/10.1186/s12890-022-01911-5