Respiratory-associated deaths in people with intellectual disabilities: a systematic review and meta-analysis

Truesdale, M. et al. (2021) Respiratory-associated deaths in people with intellectual disabilities: a systematic review and meta-analysis. BMJ Open, 11(7), e043658. (doi: 10.1136/bmjopen-2020-043658) (PMID:34261677)

Abstract

Objective: To review and synthesise evidence on rates of respiratory-associated deaths and associated risk factors in the intellectual disability population. Design: Systematic review and meta-analysis. Data sources: Embase, CINAHL, ISI Web of Science (all databases including Medline) and PsychINFO were searched for studies published between 1st January 1985 and 27th April 2020 and examined study and outcome quality. Reference lists and Google Scholar were also hand searched. Results: We identified 2295 studies, 17 were included in the narrative synthesis and 10 studies (11 cohorts) in the meta-analysis. Data from 90 302 people with intellectual disabilities and 13 808 deaths from all causes in people with intellectual disabilities were extracted. Significantly higher rates of respiratory-associated deaths were found among people with intellectual disabilities (standardised mortality ratio(SMR): 10.86 (95% CI: 5.32 to 22.18, p<0.001) compared with those in the general population, lesser rates for adults with ID (SMR: 6.53 (95% CI: 4.29 to 9.96, p<0.001); and relatively high rates from pneumonia 26.65 (95% CI: 5.63 to 126.24, p<0.001). The overall statistical heterogeneity was I2=99.0%. Conclusion: Premature deaths due to respiratory disorders are potentially avoidable with improved public health initiatives and equitable access to quality healthcare. Further research should focus on developing prognostic guidance and validated tools for clinical practice to mitigate risks of respiratory-associated deaths. PROSPERO registration number: CRD42020180479.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hughes, Mrs Laura and Dunn, Mrs Kirsty and Smith, Ms Gillian and Jani, Dr Bhautesh and Barlow, Ms Fiona and Henderson, Mrs Angela and Truesdale, Dr Maria and Symonds, Dr Joseph and Rydzewska, Dr Ewelina and Cairns, Professor Deborah and Mcgarty, Dr Arlene and Melville, Professor Craig
• Authors: Truesdale, M., Melville, C., Barlow, F., Dunn, K., Henderson, A., Hughes-Mccormack, L. A., McGarty, A., Rydzewska, E., Smith, G. S., Symonds, J., Jani, B., and Kinnear, D.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 14 July 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in BMJ Open 11(7): e043658
• Publisher Policy: Reproduced under a Creative Commons License

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Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
169698		Scottish Learning Disability Observatory (SLDO) to facilitate with SCOTPHN and NHS Boards to deliver Recommendation 9 of The keys to life.	Craig Melville	Scottish Government (SCOTGOV)	Cooper, Prof Sally-Ann	HW - Mental Health and Wellbeing