Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Eur J Neurol. 2024 Dec;31(12):e16449. doi: 10.1111/ene.16449. Epub 2024 Sep 5.
This study was undertaken to conduct a meta-analysis on the prevalence of aspiration pneumonia (AP) and hospital mortality in Parkinson disease (PD) as well as the risk of AP in PD patients compared to controls.
We searched MEDLINE and Embase from inception to 19 March 2024 to identify cross-sectional, cohort, and case-control studies comparing the frequency of AP and hospital mortality in PD patients. We computed risk ratios (RRs) with accompanying 95% confidence intervals (CIs) for each study and pooled the results using a random-effects meta-analysis.
A total of 781 studies were initially screened, and 13 studies involving 541,785,587 patients were included. Patients with PD had >3 times higher risk of AP compared to controls (RR = 3.30, 95% CI = 1.82-6.00, p < 0.0001). This increased risk was similar in both cohort studies (RR = 3.01, 95% CI = 1.10-8.24, p = 0.03) and case-control studies (RR = 3.86, 95% CI = 3.84-3.87, p < 0.00001). The prevalence of AP in 12 studies was 2.74% (95% CI = 1.69-4.41), and hospital mortality was 10% in six studies (10.0%, 95% CI = 5.32-18.0). Prevalence of AP was higher in studies with smaller sample size (5.26%, 95% CI = 3.08-8.83 vs. 2.06%, 95% CI = 1.19-3.55, p = 0.02).
Our meta-analysis showed that patients with PD had >3 times higher risk of AP, with an average 2.74% prevalence and 10.0% hospital mortality. Early recognition and treatment of AP in PD patients will help reduce morbidity and mortality. A multidisciplinary holistic approach is needed to address the multifactorial causes of AP.
本研究旨在对帕金森病（PD）患者中吸入性肺炎（AP）的患病率和住院死亡率进行荟萃分析，并与对照组比较 PD 患者患 AP 的风险。
我们检索了 MEDLINE 和 Embase 从成立到 2024 年 3 月 19 日，以确定比较 PD 患者 AP 频率和住院死亡率的横断面、队列和病例对照研究。我们为每项研究计算了风险比（RR）及其伴随的 95%置信区间（CI），并使用随机效应荟萃分析汇总结果。
共初步筛选出 781 项研究，纳入了 13 项涉及 541785587 名患者的研究。与对照组相比，PD 患者患 AP 的风险高出 3 倍以上（RR=3.30，95%CI=1.82-6.00，p<0.0001）。这一风险增加在队列研究（RR=3.01，95%CI=1.10-8.24，p=0.03）和病例对照研究（RR=3.86，95%CI=3.84-3.87，p<0.00001）中相似。12 项研究中 AP 的患病率为 2.74%（95%CI=1.69-4.41），6 项研究中住院死亡率为 10.0%（10.0%，95%CI=5.32-18.0）。在样本量较小的研究中，AP 的患病率更高（5.26%，95%CI=3.08-8.83 与 2.06%，95%CI=1.19-3.55，p=0.02）。
我们的荟萃分析表明，PD 患者患 AP 的风险高出 3 倍以上，平均患病率为 2.74%，住院死亡率为 10.0%。早期识别和治疗 PD 患者的 AP 将有助于降低发病率和死亡率。需要采取多学科整体方法来解决 AP 的多种病因。
