All-Cause and Cause-Specific Mortality in Chronic Obstructive Pulmonary Disease: A Systematic Review and...

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Public Health

Background:

• Chronic obstructive pulmonary disease (COPD) represents a significant global health challenge, contributing to substantial mortality and socioeconomic burdens.
• Understanding mortality risks associated with COPD is crucial for developing effective public health strategies and clinical interventions.

Purpose of the Study:

• To conduct a meta-analysis synthesizing evidence on all-cause and cause-specific mortality risks in COPD populations.
• To identify high-risk subgroups within the COPD population to inform precision management strategies.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Embase, Web of Science, Cochrane Library) up to April 10, 2025.
• Cohort studies reporting mortality risks in COPD patients were included. Data extraction and quality assessment were performed independently. Meta-analyses and sensitivity analyses were employed to pool and validate risks.

Main Results:

• COPD patients exhibited significantly higher all-cause mortality (HR, 1.80) compared to non-COPD individuals.
• Mortality risk increased progressively with COPD severity (mild to very severe).
• Smoking status and comorbidities, particularly respiratory diseases, cardiovascular diseases, and cancers (especially lung cancer), were associated with amplified mortality risks in COPD patients.

Conclusions:

• COPD is associated with substantially elevated death risks, which are exacerbated by disease severity, smoking, and the presence of comorbidities.
• These findings underscore the need for targeted interventions addressing smoking cessation and managing comorbidities to reduce COPD-related mortality.
• The study provides a robust evidence base for precision management strategies aimed at mitigating mortality in high-risk COPD subgroups.