Long-Term Risk of Mortality Associated with Isolation of Pseudomonas aeruginosa in COPD : A Systematic Review and Meta-Analysis
Martinez-García, Miguel Angel (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Rigau, David (Institut d'Investigació Biomèdica Sant Pau)
Barrecheguren, Miriam (Hospital Universitari Vall d'Hebron. Institut de Recerca)
García-Ortega, Alberto (Hospital Universitari i Politècnic La Fe (València))
Nuñez, Alexa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Oscullo Yepez, Grace (Hospital Universitari i Politècnic La Fe (València))
Miravitlles, Marc (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2022
Resum:	Background: Chronic bronchial infection is frequent in chronic obstructive pulmonary disease (COPD), but the impact of the isolation of pathogenic bacteria, and in particular Pseudomonas aeruginosa (PA) in respiratory samples on the prognosis of COPD is unclear. Methods: We conducted a systematic review of prognostic studies including patients with isolation of PA in sputum in stable state or during exacerbations of COPD. The main outcomes were all-cause mortality, respiratory mortality, and number and severity of future exacerbations. Data were expressed as hazard ratio (HR) (95% confidence interval [CI]) whenever possible. Results: Of 2773 studies, eight were finally included (23,228 individuals). The mean age ranged from 65. 5 to 73 years. Six studies reported data for all-cause mortality. The adjusted risk of death was almost double in patients with PA isolation (HR 1. 95, 95% CI, 1. 34 to 2. 84; quality of evidence moderate). Patients with PA isolation showed a three times higher adjusted risk of readmission at 30 days after discharge (OR 3. 60, 95% CI, 3. 60 to 12. 03, 1 study; quality of evidence very low), and more than double adjusted risk of death and hospitalization at two years (HR 2. 80, 95% CI, 2. 20 to 3. 56, 1 study; quality of evidence very low). Conclusion: There is moderate certainty that the isolation of PA in sputum is associated with an adjusted increased risk of death in patients with COPD.
Nota:	Altres ajuts: Boehringer Ingelheim Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COPD ; Prognosis ; Outcomes ; Mortality ; Exacerbations ; Bronchial infection ; Bronchial colonization
Publicat a:	International journal of COPD, Vol. 17 (2022) , p. 371-382, ISSN 1178-2005

DOI: 10.2147/COPD.S346294
PMID: 35210766

12 p, 2.1 MB

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