慢性阻塞性肺疾病患者住院时间延长危险因素的Meta分析

目的明确慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者住院时间延长的危险因素,为临床患者的早期干预提供依据。方法系统检索中国知网、万方、维普、Pubmed、Web of Science及Cochrane library数据库,收集COPD患者住院时间延长危险因素的队列研究、病例对照研究,检索时限为建库至2020年8月。运用RevMan 5.3软件进行Meta分析。结果纳入12项研究,样本量为23017例。COPD患者住院时间延长的危险因素有9项,即白蛋白水平异常(OR=-2.71)、血红蛋白水平异常(OR=-1.23)、入院FEVI%值异常(OR=-5.83)、GLOD4级(OR=1.57)、合并慢性肾脏疾病(OR=2)、有ICU入住史(OR=7.8)、住院期间使用无创呼吸机(OR=1.94)、住院期间使用有创呼吸机(OR=4.42)及需要进行家庭氧疗(OR=2.36)等。结论临床医护人员应针对危险人群,加强对其评估和管理,从而尽可能地减少COPD患者住院时间延长的发生,改善患者临床预后。

Risk Factors of Prolonged Hospitalization for Patients with Chronic Obstructive Pulmonary Disease :A Meta Analysis

Objective To identify the risk factors for prolonged hospitalization for the patients with Chronic Obstructive Pulmonary Disease(COPD),and to provide the basis for the clinical intervention in the early stage.Methods A systematical search in CNKI,Wanfang,VIP,PubMed,Web of Science and Cochrane Library was conducted.cohort studies and case-control studies on risk factors for prolonged hospitalization of COPD patients published from inception to August 2020 were retrieved.RevMan 5.3 software was used for Meta analysis.Results A total of 12 articles were included,with a sample size of 23017 cases,including 9 risk factors:abnormal albumin level(OR=-2.71),abnormal hemoglobin level(OR=-1.23),abnormal FEVI%value on admission(OR=-5.83),GLOD4 level(OR=1.57),complicated chronic kidney disease(OR=2),ICU admission history(OR=7.8),usage of non-invasive ventilator during hospitalization(OR=1.94),invasive ventilator during hospitalization(OR=4.42)and home oxygen therapy(OR=2.36).Conclusions Clinical medical staff should strengthen the assessment and management of risk groups,so as to reduce the occurrence of prolonged hospitalization in COPD patients as much as possible and improve the clinical outcome of patients.