Association between muscular atrophy and mortality risk in patients with COPD: a systematic review

Ther Adv Respir Dis. 2024 Jan-Dec:18:17534666241304626. doi: 10.1177/17534666241304626.

Abstract

Background: Muscular atrophy often can be seen at the end of stage in many chronic diseases. It will also negatively influence patients' outcomes. Different studies showed that the association between muscular atrophy and mortality in patients with chronic obstructive pulmonary disease (COPD) was unclear. This study will continue to assess the influence of muscular atrophy on mortality in patients with COPD.

Objectives: To systematically evaluate the association between muscular atrophy and death in patients with COPD.

Design: Systematic review.

Methods and data sources: A systematic review and meta-analysis was conducted. Databases including PubMed, Web of Science, Embase, the Cochrane Library, the China Biomedical Literature Service System, China Biomedical Literature Service System (CINAHL), China National Knowledge Infrastructure, the Wanfang database, and the WeiPu (VIP) were systematically searched for cohort studies on muscular atrophy and COPD from inception to July 1st, 2023. Two reviewers independently review, assess, and extract data from the included studies. Meta-analysis was performed using RevMan 5.4 software.

Results: Thirteen cohort studies were ultimately included, involving 10,528 patients with COPD. There were seven cohort studies included in the meta-analysis, including 3,458 COPD patients. The meta-analysis showed that patients with COPD combined with muscular atrophy had a higher mortality risk (HR = 2.20, 95%CI (1.74, 2.79), p < 0.00001). At the same time, patients with COPD who had muscular atrophy may had longer hospital stays.

Conclusion: Muscular atrophy is associated with the mortality and disease prognosis of patients with COPD. The conclusion needs to be supported and validated by more high-quality studies given the limitation of the number of articles included in this study.

Trial registration: This systematic review protocol was prospectively registered with PROSPERO (No. CRD42024589435).

Keywords: Sarcopenia; chronic obstructive pulmonary disease; mortality; muscular atrophy; systematic review.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscular Atrophy* / mortality
  • Muscular Atrophy* / physiopathology
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive* / mortality
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Risk Assessment
  • Risk Factors