Healthcare Evaluation Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Centre Hospitalier du Valais Romand, Sion, Switzerland Division of Pulmonary Medicine, Geneva University Hospital, Geneva, Switzerland.
Thorax. 2014 Sep;69(9):865-6. doi: 10.1136/thoraxjnl-2013-204983. Epub 2014 Apr 9.
Concerns about increased mortality could question the role of COPD chronic disease management (CDM) programmes. We aimed at extending a recent Cochrane review to assess the effects of CDM on mortality in patients with COPD.
Mortality data were available for 25 out of 29 trials identified in a COPD integrated care systematic review. Meta-analysis using random-effects models was performed, followed by subgroup analyses according to study length (3-12 months vs >12 months), main intervention component (exercise, self-management, structured follow-up) and use of an action plan.
The meta-analysis showed no impact of CDM on mortality (pooled OR: 1.00, 95% CI 0.79 to 1.28).
These results do not suggest that CDM programmes expose patients with COPD to excessive mortality risk.
对死亡率增加的担忧可能会质疑 COPD 慢性病管理 (CDM) 计划的作用。我们旨在扩展最近的 Cochrane 综述，以评估 CDM 对 COPD 患者死亡率的影响。
在 COPD 综合护理系统评价中确定的 29 项试验中有 25 项提供了死亡率数据。使用随机效应模型进行荟萃分析，然后根据研究时间（3-12 个月与 >12 个月）、主要干预成分（运动、自我管理、结构化随访）和行动计划的使用情况进行亚组分析。
荟萃分析显示 CDM 对死亡率没有影响（汇总 OR：1.00，95%CI 0.79 至 1.28）。
这些结果表明，CDM 计划不会使 COPD 患者面临过高的死亡风险。
