ABSTRACT

Objectives

To assess risk factors for mortality in invasive pneumococcal disease (IPD).

Methods

We conducted a systemic literature search in January 2019. The main outcome measure included death within 30 days after diagnosis of IPD. The study protocol was registered in PROSPERO (CRD42019120189).

Results

After reviewing 2514 potentially relevant records, remaining 190 articles were included in the analysis. A total of 228,782 IPD patients were identified and the mortality rate was 17.2% in the included articles. No significant evidence of publication bias was found according to the funnel plot and Egger’s test (t = 1.464, p = 0.145). Male sex, older age, alcohol abuse, previous tuberculosis, meningitis, hospital acquired infections, multilobar infiltrate or effusion, Pitt bacteremia score≥4, Pneumonia Severity Index≥4, clinical conditions requiring intensive care, underlying clinical conditions, disease caused by serotypes 3, 6B, 9 N, 10A, 11A, 16 F, 17 F, 19, 19 F, 22 F, 23A, 23 F, 31 and 35 F, previous antibiotic use, inappropriate initial antibiotic therapy, penicillin resistance, and vancomycin use during the course of treatment were predicators of 30-day mortality.

Conclusions

This meta-analysis highlights important risk factors for IPD-related mortality, many of which may be targeted through preventive measures.

中文翻译：

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侵袭性肺炎球菌疾病死亡率的预测因素：荟萃分析

摘要

目标

评估侵袭性肺炎球菌病 (IPD) 死亡率的危险因素。

方法

我们于 2019 年 1 月进行了系统文献检索。主要结局指标包括 IPD 诊断后 30 天内的死亡。研究方案已在 PROSPERO (CRD42019120189) 中注册。

结果

在审查了 2514 条可能相关的记录后，剩余的 190 篇文章被纳入分析。纳入文献共确定IPD患者228782例，死亡率17.2%。根据漏斗图和 Egger 检验（t = 1.464, p= 0.145）。男性、高龄、酗酒、既往肺结核、脑膜炎、医院获得性感染、多叶浸润或渗出、皮特菌血症评分≥4、肺炎严重程度指数≥4、需要重症监护的临床情况、基础临床情况、血清型3引起的疾病, 6B, 9 N, 10A, 11A, 16 F, 17 F, 19, 19 F, 22 F, 23A, 23 F, 31 and 35 F, 既往抗生素使用, 不适当的初始抗生素治疗, 青霉素耐药性, 和万古霉素使用期间治疗过程是 30 天死亡率的预测因素。

结论

这项荟萃分析强调了 IPD 相关死亡率的重要风险因素，其中许多可能通过预防措施成为目标。