Meta-Analysis
Copyright ©The Author(s) 2022.
World J Clin Cases. Apr 26, 2022; 10(12): 3787-3800
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3787
Table 1 Characteristics of the studies included (n = 17)
No.
Ref.
Country
Study design
Sample size
Mean age (in years)
Study participants
Risk factors reported
1Ahmedani et al[33], 2015United StatesRetrospective analysis of data72438NRAll health plan patients at the participating health systems with an index inpatient hospitalization for pneumonia between January 2009 and December 2011Dementia
2Buja et al[36], 2020ItalyRetrospective cohort study6258NRResidents aged ≥ 65 yr with diagnosis related groups pneumonia (DRG 89 or 90)Gender
3Chakrabarti et al[22], 2021United KingdomRetrospective analysis of data1036673All community acquired pneumonia cases submitted by the nine participating hospitals in the AQ Pneumonia Programme between January 1, 2017 and March 31, 2019Gender, Dementia, Heart failure, Cancer, CRD, CKD, DM, IHD, Cerebrovascular disease
4Dharmarajan et al[29], 2013United StatesRetrospective analysis of data214239NRHospitalizations among patients 65 yr or older with a complete claims history for 1 yr preceding admissionGender
5Dong et al[30], 2017United StatesRetrospective cohort study289261Medical records of all 2892 patients coded with a principal diagnosis of pneumonia admitted to the University of ChicagoAge, Gender, Cancer, Heart Failure, CKD, CRD, Cerebrovascular disease
6Faverio et al[31], 2020ItalyRetrospective cohort study20376871.2NHS eligible residents in Lombardy who had experienced at least one hospital admission with pneumonia as primary or secondary diagnosis during the years 2003 to 2012Gender, Cancer, CKD, CRD, CLD, Cerebrovascular disease, Mechanical ventilation
7Graversen et al[23], 2020DenmarkRetrospective analysis of data298564NRAll Danish residents aged 65-99 yr, who had been discharged after a pneumonia-related hospital admission, referred to as index admission, during our study periodGender, Dementia, Heart failure, Cancer, CRD, DM
8Graversen et al[24], 2021DenmarkRetrospective analysis of data298872NRAll Danish citizens aged 65–99 yr, who were discharged after a hospital admission (index admission) with a primary or secondary diagnosis of pneumonia as defined by the allocation of diagnostic codes (ICD-10: J12-J18, A709, or A481)Dementia
9Jain et al[34], 2018United States of AmericaRetrospective analysis of data147207068.9All adults discharged alive after a hospitalization with the primary diagnosis of pneumoniaAge
10Jang et al[35], 2020KoreaRetrospective cohort86268.5Patients with community acquired pneumonia hospitalized at Yeungnam University Hospital from March 2012 to February 2014Age, Gender, Dementia, Heart failure, Cancer, CRD, DM, CKD, CLD, Cerebrovascular disease, ICU admission, Mechanical ventilation
11Knox[32], 2019United StatesRetrospective analysis of data38995679Pneumonia patients ranging in age from 65 to 90 yr of ageDementia
12Lee et al[25], 2017Republic of KoreaRetrospective cohort7446NRPatients older than 65 yr who were hospitalized with pneumonia between 2003 and 2013Gender, Dementia, Heart failure, Cancer, CRD, CKD
13Mather et al[11], 2013United StatesRetrospective cohort956NRAdult patients admitted to Hartford Hospital from January 2009 to March 2012 with principal diagnosis of pneumonia (International Classification of Diseases, 9th Revision, Clinical Modification codes 480.XX, 481, 482.XX, 483.X, 485, 486, and 487.0) as potential index pneumonia admissionGender, Dementia, Heart failure, Cancer, CRD, CKD, DM, IHD
14Nagasako et al[27], 2014United StatesRetrospective analysis of data29849NRHospital readmissions for patients discharged from non-federal Missouri acute care or critical access hospitals between June 1, 2009 and May 31, 2012, with principal diagnoses of pneumoniaGender
15Shams et al[28], 2014United StatesRetrospective cohort130668.3Adult patients with principal (or secondary) discharge diagnoses of pneumoniaGender, Cancer, Heart Failure, CRD, DM, IHD
16Shorr et al[12], 2013United StatesRetrospective cohort77160All adult subjects with bacterial pneumonia admitted to a single institution between January and December 2010Gender, Cancer, Dementia, Heart Failure, ICU admission, Mechanical ventilation, Cerebrovascular disease, CRD, DM, IHD
17Toledo et al[26], 2018SpainCross-sectional1756NRPatients included were aged ≥ 65 yr admitted through the emergency department to any of the participating hospitals for ≥ 24 h with a chest X ray showing pulmonary infiltrate compatible with pneumonia and ≥ 1 of the following symptoms or signs of acute lower respiratory tract infection: Cough, pleural chest pain, dyspnoea, fever > 38 °C, hypothermia < 35 °C and abnormal auscultator respiratory sounds unexplained by other causesGender, Heart failure, Cancer, CRD, CKD, DM
NR: Not reported; CRD: Chronic respiratory diseases; CKD: Chronic kidney disease; CLD: Chronic liver disease; DM: Diabetes mellitus; IHD: Ischaemic heart disease; NHS: National Health Service.
Table 2 Quality assessment of the included studies (n = 17)
No.
Ref.
Representativeness
Sample size justification
Non-response
Ascertainment of exposure
Control for confounding
Assessment of outcome
Statistical tests
Overall quality
1Ahmedani et al[33], 20151 star0 star0 star1 star2 stars1 star1 starSatisfactory
2Buja et al[36], 20201 star1 star1 star1 star2 stars1 star1 starGood
3Chakrabarti et al[22], 20211 star0 star1 star1 star2 stars1 star1 starGood
4Dharmarajan et al[29], 20131 star1 star0 star1 star2 stars1 star1 starGood
5Dong et al[30], 20170 star0 star0 star1 star2 stars1 star1 starSatisfactory
6Faverio et al[31], 20201 star0 star0 star1 star2 stars1 star1 starSatisfactory
7Graversen et al[23], 20201 star1 star1 star1 star2 stars1 star1 starGood
8Graversen et al[24], 20211 star0 star1 star1 star2 stars1 star1 starGood
9Jain et al[34], 20181 star1 star0 star1 star2 stars1 star1 starGood
10Jang et al[35], 20201 star1 star1 star1 star2 stars1 star1 starGood
11Knox[32], 20190 star0 star0 star1 star0 star1 star0 starUnsatisfactory
12Lee et al[25], 20171 star1 star1 star1 star2 stars1 star1 starGood
13Mather et al[11], 20131 star0 star1 star1 star2 stars1 star1 starGood
14Nagasako et al[27], 20140 star1 star0 star0 star0 star1 star1 starUnsatisfactory
15Shams et al[28], 20140 star1 star0 star1 star0 star1 star0 starUnsatisfactory
16Shorr et al[12], 20131 star1 star1 star1 star2 stars1 star1 starGood
17Toledo et al[26], 20181 star0 star1 star1 star2 stars1 star1 starGood