Journal article
Association of Nonobstructive Chronic Bronchitis With All-Cause Mortality A Systematic Literature Review and Meta-analysis
Chest, Vol.162(1), pp.92-100
07/01/2022
DOI: 10.1016/j.chest.2022.02.003
PMID: 35150657
Abstract
BACKGROUND: The effect of nonobstructive chronic bronchitis (CB) on mortality is unclear.
RESEARCH QUESTION: Is nonobstructive CB associated with increased all-cause mortality?
STUDY DESIGN AND METHODS: We conducted a systematic literature review and meta-analysis to assess the association of nonobstructive CB and all-cause mortality. We searched for articles that included both CB and mortality in the title, abstract, or both in PubMed and EMBASE. We excluded studies in which participants demonstrated obstructive spirometry findings and studies in which CB and mortality were not defined. We used the Newcastle-Ottawa Quality Assessment Scale to assess study quality. We pooled adjusted hazard ratios (HRs) using the random effects model and inverse variance weighting. We conducted stratified analysis by the definition of CB and smoking status. We used Cochran's Q and I-2 to assess for heterogeneity. We assessed publication bias by visual inspection of a funnel plot.
RESULT Of 5,014 titles identified, eight fulfilled the inclusion and exclusion criteria. Overall nonobstructive CB was associated with all-cause mortality (HR, 1.37; 95% CI, 1.26-1.50) with no statistically significant heterogeneity (P = .14; I-2 = 29%). Nonobstructive CB was associated with increased mortality in studies that defined CB as any respiratory symptoms (broad definition; HR, 1.28; 95% CI, 1.10-1.48; I-2 = 0%) as well as in the rest of the studies (HR, 1.40; 95% CI, 1.26-1.56; I-2 = 37%). Nonobstructive CB was associated with increased mortality in ever smokers (HR, 1.49; 95% CI, 1.35-1.64; I-2 = 0%), but was not associated with increased mortality in never smokers (HR, 1.22; 95% CI, 0.90-1.66), and moderate heterogeneity was found (P = .10; I-2 = 49%). The funnel plot did not indicate evidence of a publication bias because it showed symmetrical distribution of studies.
INTERPRETATION: Nonobstructive CB is associated with increased all-cause mortality, and this association seems to be present only in current and former smokers. Further research should investigate whether this high-risk population may benefit from early therapeutic intervention.
Details
- Title: Subtitle
- Association of Nonobstructive Chronic Bronchitis With All-Cause Mortality A Systematic Literature Review and Meta-analysis
- Creators
- Spyridon Fortis - Iowa City VA Health Care SystemZacariah K. Shannon - University of IowaCrystal J. Garcia - University of IowaRodrigo Vazquez Guillamet - Washington University in St. LouisAriel M. Aloe - University of IowaMarin L. Schweizer - Iowa City VA Health Care SystemVictor Kim - Temple UniversityRajeshwari Nair - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.162(1), pp.92-100
- Publisher
- Elsevier
- DOI
- 10.1016/j.chest.2022.02.003
- PMID
- 35150657
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Number of pages
- 9
- Grant note
- 14380 / Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center; US Department of Veterans Affairs CIN 13-412 / Health Services Research and Development Service through the Comprehensive Access and Delivery Research and Evaluation Center
- Language
- English
- Date published
- 07/01/2022
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Epidemiology; Family and Community Medicine; General Internal Medicine; Psychological and Quantitative Foundations; Internal Medicine
- Record Identifier
- 9984359893002771
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