Prevalence and impact of comorbid laryngeal dysfunction in asthma: A systematic review and meta-analysis
Autor: | Ha-Kyeong Won, Woo-Jung Song, Ji Hyang Lee, You Sook Cho, Hee-Bom Moon, Jin An, Tae-Bum Kim, Hyouk-Soo Kwon, James H. Hull, Yewon Kang |
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Rok vydání: | 2020 |
Předmět: |
Adult
medicine.medical_specialty Immunology Laryngoscopy Computed tomography Comorbidity Laryngeal Diseases 03 medical and health sciences 0302 clinical medicine Quality of life Internal medicine Prevalence medicine Vocal cord dysfunction Humans Immunology and Allergy 030212 general & internal medicine Prospective cohort study Asthma medicine.diagnostic_test business.industry medicine.disease 030228 respiratory system Meta-analysis business |
Zdroj: | Journal of Allergy and Clinical Immunology. 145:1165-1173 |
ISSN: | 0091-6749 |
DOI: | 10.1016/j.jaci.2019.12.906 |
Popis: | Background Laryngeal or vocal cord dysfunction has long been regarded as a mimic of asthma; however, recent evidence indicates that it may be a significant comorbid condition in patients with asthma. Objective We aimed to systematically estimate the prevalence of comorbid laryngeal dysfunction (LD) in adults with asthma and characterize its clinical impact on asthma. Methods Electronic databases were searched for relevant studies published until June 2019. Studies were included if LD was objectively defined by direct visualization of laryngeal movement. Outcomes included the prevalence of LD and its association with clinical asthma indicators, such as severity, control, and quality of life. Random effects meta-analyses were performed to calculate the estimates. Results A total of 21 studies involving 1637 patients were identified. Overall, the pooled prevalence of LD in adults with asthma was 25% (95% CI = 15%-37%; I2 = 96%). Prevalence estimates differed according to the diagnostic test utilized, with the lowest overall prevalence (4% [95% CI = 0%-10%; I2 = 90%]) seen when LD was diagnosed by resting laryngoscopy without external stimuli; however, it was much higher when diagnosed by laryngoscopy studies utilizing an external trigger, such as exercise (38% [95% CI = 24%-53%; I2 = 90%]) or in studies using a computed tomography–based diagnostic protocol (36% [95% CI = 24%-49%; I2 = 78%]). Only 7 studies reported the associations between LD and clinical asthma indicators; inconsistencies between studies limited meaningful conclusions. Conclusion LD may be a common comorbidity in asthma, affecting about 25% of adult patients. Further prospective studies are needed to better characterize its clinical impact and the benefits of detecting and managing LD in patients with asthma. |
Databáze: | OpenAIRE |
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