Risk factors of ventilator-associated pneumonia in patients with acute exacerbation of chronic obstructive pulmonary disease: a meta-analysis and systematic review
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: This meta-analysis aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients with Acute exacerbations of Chronic obstructive pulmonary disease (AECOPD). METHODS: We systematically searched PubMed, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, and other databases for studies investigating risk factors for VAP in patients experiencing AECOPD. The search encompassed records from database inception up to July 2, 2025. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using Stata 18.0. RESULTS: A total of 16 articles were included, encompassing 3,664 subjects and 16 risk factors. Meta-analysis results showed that, Age (OR: 2.49, 95%CI : 1.49, 4.17; P < 0.001), Smoking history (OR: 2.70, 95%CI : 1.65, 4.44; P < 0.001), Acute physiology and chronic health evaluation composite score (APACHE Ⅱ) score (OR: 3.03, 95%CI : 1.98, 4.65; P < 0.001), Sequential organ failure assessment (SOFA) score (OR: 2.75, 95%CI : 1.90, 3.99; P < 0.001), Diabetes (OR: 2.11, 95%CI : 1.38, 3.24; P = 0.001), Underlying Diseases (OR: 3.42, 95%CI : 1.85, 6.32; P < 0.001), Duration of mechanical ventilation (OR: 4.53, 95%CI : 2.68, 7.65; P < 0.001), Tracheal intubation (OR: 4.21, 95%CI : 1.85, 9.57; P = 0.001), Indwelling gastric tube (OR: 3.31, 95%CI : 1.38, 7.95; P = 0.008), Total parenteral nutrition (OR: 1.86, 95%CI : 1.29, 2.70; P = 0.001), Combined antibiotics (OR: 2.79, 95%CI : 1.32, 5.93; P = 0.007), Tracheotomy (OR: 2.92, 95%CI : 2.04, 4.17; P < 0.001), History of mechanical ventilation within one year (OR: 2.92, 95%CI : 2.04, 4.17; P = 0.005), Use acid suppressants (OR: 2.10, 95%CI : 1.49, 2.97; P < 0.001) were associated with the development of VAP in AECOPD patients. CONCLUSIONS: This study identified 14 risk factors associated with the risk of VAP in AECOPD patients. This finding is helpful for early identification of high-risk patients, which is of great value for reducing mortality and improving the clinical prognosis of patients with mechanical ventilation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.013 | 0.002 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".