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比较侵袭性曲霉菌病患者与非侵袭性曲霉菌病患者年龄差异的系统评价和荟萃分析。

Age difference of patients with and without invasive aspergillosis: a systematic review and meta-analysis.

机构信息

Medical Research Council Centre for Medical Mycology, Geoffrey Pope Building, University of Exeter, University of Exeter, Stocker Road, Exeter, EX4 4QD, UK.

School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK.

出版信息

BMC Infect Dis. 2024 Feb 19;24(1):220. doi: 10.1186/s12879-024-09109-2.

Abstract

BACKGROUND

Invasive Aspergillosis (IA) is a life-threatening fungal disease with significant mortality rates. Timely diagnosis and treatment greatly enhance patient outcomes. This study aimed to explore the association between patient age and the development of IA, as well as the potential implications for risk stratification strategies.

METHODS

We searched National Center for Biotechnology Information (NCBI) databases for publications until October 2023 containing age characteristics of patients with and without IA. A random-effects model with the application of inverse-variance weighting was used to pool reported estimates from each study, and meta-regression and subgroup analyses were utilized to assess sources of heterogeneity.

RESULTS

A systematic review was conducted, resulting in the inclusion of 55 retrospective observational studies with a total of 13,983 patients. Meta-analysis revealed that, on average, patients with IA were approximately two and a half years older (95% Confidence Interval [CI] 1.84-3.31 years; I = 26.1%) than those without the disease (p < 0.0001). No significant moderators could explain the observed heterogeneity in age difference. However, subgroup analysis revealed that age differences were more pronounced within particular patient groups compared to others. For example, patients with and without IA who had primary severe lung infections exhibited a greater difference in mean age than other patient cohorts.

CONCLUSIONS

Further research, such as individual patient data meta-analysis, is necessary to better understand the potential relationship between increasing age and the likelihood of IA. Improved risk stratification strategies based on patient age could potentially enhance the early detection and treatment of IA, ultimately improving patient outcomes.

摘要

背景

侵袭性曲霉病(IA)是一种危及生命的真菌病,死亡率很高。及时诊断和治疗可显著改善患者预后。本研究旨在探讨患者年龄与 IA 发生之间的关系,以及这对风险分层策略的潜在影响。

方法

我们在国家生物技术信息中心(NCBI)数据库中检索了截至 2023 年 10 月发表的包含有或无 IA 患者年龄特征的文献。使用应用逆方差加权的随机效应模型汇总来自每项研究的报告估计值,并进行荟萃回归和亚组分析以评估异质性的来源。

结果

进行了系统评价,纳入了 55 项回顾性观察性研究,共纳入了 13983 例患者。荟萃分析显示,IA 患者的平均年龄比无该病患者大大约 2.5 岁(95%置信区间 [CI] 1.84-3.31 岁;I = 26.1%;p < 0.0001)。没有显著的调节因素可以解释年龄差异的观察到的异质性。然而,亚组分析显示,在特定的患者群体中,年龄差异比其他患者群体更为明显。例如,患有和不患有原发性严重肺部感染的 IA 患者的平均年龄差异大于其他患者队列。

结论

需要进一步研究,例如个体患者数据荟萃分析,以更好地理解年龄增加与 IA 发生之间的潜在关系。基于患者年龄的改进风险分层策略可能有助于提高 IA 的早期检测和治疗,从而改善患者预后。

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