{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:37:59Z","timestamp":1792730279904,"version":"4.5.0"},"reference-count":63,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the occurrence proportion and associated factors of respiratory failure during hospitalization in Chinese patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eight databases (CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library) were searched from inception to March 1, 2026. Studies reporting multivariable\u2010adjusted odds ratios (ORs) for factors associated with respiratory failure in AECOPD patients were included. The Newcastle\u2013Ottawa Scale was used for quality assessment. A single\u2010group rate meta\u2010analysis with Freeman\u2013Tukey double arcsine transformation was performed to pool the occurrence proportion. Subgroup analyses were conducted by study design, geographical region (Qinling\u2013Huaihe Line), and respiratory failure type. Factors associated with respiratory failure were stratified by definitions and cutoff values; only subgroups with \u2265\u20093 studies were pooled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010three studies (5 cohort, 18 case\u2013control) with 4212 patients were included. The pooled occurrence proportion of respiratory failure was 41% (95% CI: 0.37\u20130.46). Meta\u2010analysis identified nine factors associated with respiratory failure: comorbid cardiac disease (OR\u2009=\u20092.12, 95% CI: 1.68\u20132.67), advanced age (OR\u2009=\u20091.22, 95% CI: 1.13\u20131.33), elevated NLR (OR\u2009=\u20091.87, 95% CI: 1.50\u20132.33), elevated PCT (OR\u2009=\u20092.27, 95% CI: 1.29\u20134.00), elevated D\u2010dimer (OR\u2009=\u20091.72, 95% CI: 1.01\u20132.90), \u2265\u20092 annual exacerbations (OR\u2009=\u20092.48, 95% CI: 1.71\u20133.60), higher APACHE II score (OR\u2009=\u20091.29, 95% CI: 1.17\u20131.43), elevated CRP (OR\u2009=\u20091.13, 95% CI: 1.02\u20131.24), and decreased FEV1% predicted (OR\u2009=\u20090.81, 95% CI: 0.67\u20130.99). Model dependence analysis showed that ALB was statistically significant only under the fixed\u2010effects model but not under the random\u2010effects model. NE was not statistically significant under either model. Therefore, ALB and NE were not included among the nine factors that were statistically significant in the primary analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The occurrence proportion of respiratory failure in hospitalized Chinese AECOPD patients is high and associated with comorbidities, clinical characteristics, severity scores, and inflammatory\/coagulation markers. These findings support risk identification and monitoring, but prospective studies are needed to validate their predictive and interventional value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70237","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:58:22Z","timestamp":1792727902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occurrence Proportion and Associated Factors of Respiratory Failure During Hospitalization in Chinese Patients With AECOPD: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0600-5350","authenticated-orcid":false,"given":"Dandan","family":"Liu","sequence":"first","affiliation":[{"name":"School of Nursing Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3510-4010","authenticated-orcid":false,"given":"Minzuo","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaosi","family":"Wen","sequence":"additional","affiliation":[{"name":"School of Nursing Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingmei","family":"Pan","sequence":"additional","affiliation":[{"name":"School of Nursing Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Duan","sequence":"additional","affiliation":[{"name":"School of Nursing Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Yang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-9904","authenticated-orcid":false,"given":"Shengru","family":"Tao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/0929867322666150904113032"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn131368\u201020221123\u201001066"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102021\u2010069679"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn121430\u201020211003\u201001438"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed\u20102022\u2010000146"},{"key":"e_1_2_12_7_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease \u201cGlobal Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease (2026 Report) \u201d (2026)."},{"key":"e_1_2_12_8_1","volume-title":"Chronic Obstructive Pulmonary Disease (COPD)","author":"Kanchustambham V.","year":"2026"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2024.2441184"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1006\u20105725.2021.05.017"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S540753"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S208245"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0321470"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.09.004"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2025.111840"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.11816\/cn.ni.2024\u2010240339"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010019\u201000576\u20105"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202108\u20101819PP"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2024.01.002"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010010\u20109491\u2010z"},{"issue":"3","key":"e_1_2_12_22_1","first-page":"356","article-title":"Regional Differentiation of North and South China Under the Influence of Climate: Ecology, Production, and Life","volume":"36","author":"Hao C. 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