Pneumonia-associated death in patients with dementia: A systematic review and meta-analysis
Pneumonia is a serious disease associated with mortality among patients with dementia. However, the reported frequency of pneumonia as a cause of death in patients with dementia varies, the reason for which has not been fully elucidated. We conducted a systematic search in PubMed and the Cochrane Da...
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| Veröffentlicht in: | PloS one 2019-03, Vol.14 (3), p.e0213825-e0213825 |
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| creator | Manabe, Toshie Fujikura, Yuji Mizukami, Katsuyoshi Akatsu, Hiroyasu Kudo, Koichiro |
| description | Pneumonia is a serious disease associated with mortality among patients with dementia. However, the reported frequency of pneumonia as a cause of death in patients with dementia varies, the reason for which has not been fully elucidated.
We conducted a systematic search in PubMed and the Cochrane Database of Systematic Reviews (inception to December 2016). Two authors independently determined the suitability of studies and potential bias and extracted the data. The primary outcome was frequency of pneumonia-associated death in patients with dementia. Stratified subgroup analysis was conducted among studies grouped according to type of mortality cause (immediate or underlying), information source of mortality cause (autopsy or death certificate), and study setting (clinic, hospital, or nursing home).
We included 7 studies reporting the cause of death among patients with dementia and 12 studies comparing the cause of death among patients with and without dementia. The frequency of pneumonia-associated death among 19 eligible studies was 29.69% (95% confidence interval [CI], 25.86-33.53). Those frequencies differed according to whether the source for information about cause of death was an autopsy confirmation (49.98%; 95% CI, 43.75-56.71) or death certificate (19.65%; 95% CI, 15.48-23.83) and according to whether the type of mortality cause was an indirect cause of death (13.96%; 95% CI, 9.42-18.51) or direct cause of death (44.45%; 95% CI, 29.81-50.10). The risk of pneumonia-associated death in patients with dementia was twice as high as among those without dementia (odds ratio, 2.15; 95% CI, 1.63-2.83; p < 0.001).
The various frequencies of pneumonia-associated death in patients with dementia were associated with the information source, type of mortality cause, and study setting. Patients with dementia in the terminal stages urgently require careful clinical management of pneumonia, to maximize patient life expectancy and quality. |
| doi_str_mv | 10.1371/journal.pone.0213825 |
| format | Article |
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We conducted a systematic search in PubMed and the Cochrane Database of Systematic Reviews (inception to December 2016). Two authors independently determined the suitability of studies and potential bias and extracted the data. The primary outcome was frequency of pneumonia-associated death in patients with dementia. Stratified subgroup analysis was conducted among studies grouped according to type of mortality cause (immediate or underlying), information source of mortality cause (autopsy or death certificate), and study setting (clinic, hospital, or nursing home).
We included 7 studies reporting the cause of death among patients with dementia and 12 studies comparing the cause of death among patients with and without dementia. The frequency of pneumonia-associated death among 19 eligible studies was 29.69% (95% confidence interval [CI], 25.86-33.53). Those frequencies differed according to whether the source for information about cause of death was an autopsy confirmation (49.98%; 95% CI, 43.75-56.71) or death certificate (19.65%; 95% CI, 15.48-23.83) and according to whether the type of mortality cause was an indirect cause of death (13.96%; 95% CI, 9.42-18.51) or direct cause of death (44.45%; 95% CI, 29.81-50.10). The risk of pneumonia-associated death in patients with dementia was twice as high as among those without dementia (odds ratio, 2.15; 95% CI, 1.63-2.83; p < 0.001).
The various frequencies of pneumonia-associated death in patients with dementia were associated with the information source, type of mortality cause, and study setting. Patients with dementia in the terminal stages urgently require careful clinical management of pneumonia, to maximize patient life expectancy and quality.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0213825</identifier><identifier>PMID: 30870526</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Alzheimer's disease ; Autopsies ; Autopsy ; Care and treatment ; Cause of Death ; Confidence intervals ; Death ; Dementia ; Dementia - etiology ; Dementia - mortality ; Dementia disorders ; Health aspects ; Humans ; Life expectancy ; Life span ; Medical research ; Medicine and Health Sciences ; Meta-analysis ; Mortality ; Older people ; Patient outcomes ; Patients ; People and Places ; Physical Sciences ; Pneumonia ; Pneumonia - complications ; Prognosis ; Research and Analysis Methods ; Risk Factors ; Studies ; Subgroups ; Survival Rate ; Systematic review ; Terminally ill persons</subject><ispartof>PloS one, 2019-03, Vol.14 (3), p.e0213825-e0213825</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Manabe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Manabe et al 2019 Manabe et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c802t-fd5b8efaab4035e97be90bb8b440a98b907833dc8d75e82701ec9eb56e2818843</citedby><cites>FETCH-LOGICAL-c802t-fd5b8efaab4035e97be90bb8b440a98b907833dc8d75e82701ec9eb56e2818843</cites><orcidid>0000-0002-8208-8071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417730/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417730/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30870526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Tan, Maw Pin</contributor><creatorcontrib>Manabe, Toshie</creatorcontrib><creatorcontrib>Fujikura, Yuji</creatorcontrib><creatorcontrib>Mizukami, Katsuyoshi</creatorcontrib><creatorcontrib>Akatsu, Hiroyasu</creatorcontrib><creatorcontrib>Kudo, Koichiro</creatorcontrib><title>Pneumonia-associated death in patients with dementia: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pneumonia is a serious disease associated with mortality among patients with dementia. However, the reported frequency of pneumonia as a cause of death in patients with dementia varies, the reason for which has not been fully elucidated.
We conducted a systematic search in PubMed and the Cochrane Database of Systematic Reviews (inception to December 2016). Two authors independently determined the suitability of studies and potential bias and extracted the data. The primary outcome was frequency of pneumonia-associated death in patients with dementia. Stratified subgroup analysis was conducted among studies grouped according to type of mortality cause (immediate or underlying), information source of mortality cause (autopsy or death certificate), and study setting (clinic, hospital, or nursing home).
We included 7 studies reporting the cause of death among patients with dementia and 12 studies comparing the cause of death among patients with and without dementia. The frequency of pneumonia-associated death among 19 eligible studies was 29.69% (95% confidence interval [CI], 25.86-33.53). Those frequencies differed according to whether the source for information about cause of death was an autopsy confirmation (49.98%; 95% CI, 43.75-56.71) or death certificate (19.65%; 95% CI, 15.48-23.83) and according to whether the type of mortality cause was an indirect cause of death (13.96%; 95% CI, 9.42-18.51) or direct cause of death (44.45%; 95% CI, 29.81-50.10). The risk of pneumonia-associated death in patients with dementia was twice as high as among those without dementia (odds ratio, 2.15; 95% CI, 1.63-2.83; p < 0.001).
The various frequencies of pneumonia-associated death in patients with dementia were associated with the information source, type of mortality cause, and study setting. Patients with dementia in the terminal stages urgently require careful clinical management of pneumonia, to maximize patient life expectancy and quality.</description><subject>Alzheimer's disease</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Care and treatment</subject><subject>Cause of Death</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Dementia</subject><subject>Dementia - etiology</subject><subject>Dementia - mortality</subject><subject>Dementia disorders</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Older people</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Pneumonia</subject><subject>Pneumonia - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manabe, Toshie</au><au>Fujikura, Yuji</au><au>Mizukami, Katsuyoshi</au><au>Akatsu, Hiroyasu</au><au>Kudo, Koichiro</au><au>Tan, Maw Pin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pneumonia-associated death in patients with dementia: A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-03-14</date><risdate>2019</risdate><volume>14</volume><issue>3</issue><spage>e0213825</spage><epage>e0213825</epage><pages>e0213825-e0213825</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pneumonia is a serious disease associated with mortality among patients with dementia. However, the reported frequency of pneumonia as a cause of death in patients with dementia varies, the reason for which has not been fully elucidated.
We conducted a systematic search in PubMed and the Cochrane Database of Systematic Reviews (inception to December 2016). Two authors independently determined the suitability of studies and potential bias and extracted the data. The primary outcome was frequency of pneumonia-associated death in patients with dementia. Stratified subgroup analysis was conducted among studies grouped according to type of mortality cause (immediate or underlying), information source of mortality cause (autopsy or death certificate), and study setting (clinic, hospital, or nursing home).
We included 7 studies reporting the cause of death among patients with dementia and 12 studies comparing the cause of death among patients with and without dementia. The frequency of pneumonia-associated death among 19 eligible studies was 29.69% (95% confidence interval [CI], 25.86-33.53). Those frequencies differed according to whether the source for information about cause of death was an autopsy confirmation (49.98%; 95% CI, 43.75-56.71) or death certificate (19.65%; 95% CI, 15.48-23.83) and according to whether the type of mortality cause was an indirect cause of death (13.96%; 95% CI, 9.42-18.51) or direct cause of death (44.45%; 95% CI, 29.81-50.10). The risk of pneumonia-associated death in patients with dementia was twice as high as among those without dementia (odds ratio, 2.15; 95% CI, 1.63-2.83; p < 0.001).
The various frequencies of pneumonia-associated death in patients with dementia were associated with the information source, type of mortality cause, and study setting. Patients with dementia in the terminal stages urgently require careful clinical management of pneumonia, to maximize patient life expectancy and quality.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30870526</pmid><doi>10.1371/journal.pone.0213825</doi><tpages>e0213825</tpages><orcidid>https://orcid.org/0000-0002-8208-8071</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Alzheimer's disease Autopsies Autopsy Care and treatment Cause of Death Confidence intervals Death Dementia Dementia - etiology Dementia - mortality Dementia disorders Health aspects Humans Life expectancy Life span Medical research Medicine and Health Sciences Meta-analysis Mortality Older people Patient outcomes Patients People and Places Physical Sciences Pneumonia Pneumonia - complications Prognosis Research and Analysis Methods Risk Factors Studies Subgroups Survival Rate Systematic review Terminally ill persons |
| title | Pneumonia-associated death in patients with dementia: A systematic review and meta-analysis |
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