慢性肺性阿斯伯吉洛症的死亡率:一个系统的审查和个别患者数据的元分析
Abhinav Sengupta1, Animesh Ray1, Ashish Datt Upadhyay2
1Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
慢性肺炎 (CPA) 的死亡率很高,预测因素包括年龄,CPA亚型和并发症. 进一步的研究应该为高危患者群体量身定制治疗方法.
科学领域:
- 医学真菌学 医学真菌学
- 肺部病理学 肺部病理学
- 流行病学 流行病学
背景情况:
- 慢性肺阿斯伯吉洛症 (CPA) 呈现出显著的发病率和死亡率,尽管抗真菌治疗.
- 了解死亡率及其预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和对CPA中的死亡率进行元分析.
- 确定与CPA患者死亡率相关的关键预测因素.
主要方法:
- 在主要数据库 (MEDLINE,Scopus,Embase,Web of Science) 进行了全面的系统文献搜索,截至2023年8月.
- 包括临床研究,观察研究和试验;不包括病例报告和评论.
- 使用随机效应元分析和Cox比例危险模型进行聚合估计和多变量分析,包括个人患者数据,如有.
主要成果:
- 在79项研究 (8778名患者) 中,综合总死亡率为27%,一年死亡率为15%,五年死亡率为32%.
- 根据潜在疾病的死亡率有所不同:肺结核的25%,COPD的35%. 手术切除显示死亡率低 (3%).
- 增加年龄 (每十年增加25%的危险),恶性瘤,特定的CPA亚型 (亚急性侵袭性,慢性洞穴性) 和肺结核病史是显著的死亡预测因素.
结论:
- CPA与大量的死亡率有关.
- 年龄,CPA亚型和潜在的并发症是关键的死亡率预测因素.
- 未来的研究应该专注于CPA的风险分层治疗策略.
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