Zhang Nai, Liu Yujuan, Yang Chuang, Zeng Peng, Gong Tao, Tao Lu, Li Xinai
Department of Emergency, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, China.
Department of Respiratory Medicine, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, China.
Tob Induc Dis. 2022 Jul 15;20:65. doi: 10.18332/tid/150340. eCollection 2022.
Although some research papers have suggested that smoking may increase mortality in patients with sepsis, no evidence has been produced in this regard. This systematic research evaluated the risk of death in patients with sepsis who were smokers to facilitate better clinical decision making.
This is a systematic review registered in PROPERO (CRD42022296654). Searches were conducted to identify suitable studies from the databases of PubMed, Embase, Web of Science and the Cochrane Controlled Register of Trials from January 1980 to June 2021. Two independent reviewers screened the articles using keywords and extracted the data. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of evidence. The primary endpoints included the mortality of patients with sepsis.
Five studies involving 2694 participants were included in our study. Among the five included articles, three studies had an NOS score of 6, while the other two had an NOS score of 7. The results showed that a significantly higher risk of death was observed in smokers with sepsis compared with non-smokers with sepsis (hazard ratio, HR=1.62; 95% CI: 1.11-2.37, p=0.01). Among the patients followed for more than 2 months, the mortality rate of smokers was significantly higher (2.33 times) than that of non-smokers (HR=2.33; 95% CI: 1.83-2.96, p<0.01). The difference in mortality did not reach statistical significance when the follow-up period was shorter than 2 months (HR=1.22; 95% CI: 0.96-1.56, p=0.10).
Smoking increased mortality in patients with sepsis when the follow-up period was longer than 2 months.
尽管一些研究论文表明吸烟可能会增加脓毒症患者的死亡率，但在这方面尚未有证据。这项系统性研究评估了吸烟的脓毒症患者的死亡风险，以促进更好的临床决策。
这是一项在国际前瞻性注册系统（PROSPERO，注册号CRD42022296654）注册的系统性综述。通过检索1980年1月至2021年6月期间PubMed、Embase、Web of Science数据库以及Cochrane对照试验注册中心，以识别合适的研究。两名独立评审员使用关键词筛选文章并提取数据。采用纽卡斯尔-渥太华量表（NOS）评估证据质量。主要终点包括脓毒症患者的死亡率。
我们的研究纳入了五项涉及2694名参与者的研究。在纳入的五篇文章中，三项研究的NOS评分为6分，另外两项为7分。结果显示，与非吸烟的脓毒症患者相比，吸烟的脓毒症患者死亡风险显著更高（风险比，HR = 1.62；95%置信区间：1.11 - 2.37，p = 0.01）。在随访超过2个月的患者中，吸烟者的死亡率显著更高（是不吸烟者的2.33倍）（HR = 2.33；95%置信区间：1.83 - 2.96，p < 0.01）。当随访期短于2个月时，死亡率差异未达到统计学意义（HR = 1.22；95%置信区间：0.96 - 1.56，p = 0.10）。
当随访期超过2个月时，吸烟会增加脓毒症患者的死亡率。
