Role Of Sputum Purulence In Correlation To Bacterial Exacerbation Of Chronic Obstructive Pulmonary Disease:a Meta-analysis

Objective:In clinical practice, limited methods are available to physicians to efficiently identify bacterial infection in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In this report, we aimed to systematically review the evidence regarding the correlation between sputum purulence and bacterial exacerbation of COPD patients.Methods:We searched Medline, Embase, Cochrane Controlled Clinical Trials Register Database, the National Institutes for Health (NIH) ClinicalTrials.gov Register, and Current Controlled Trials. Five studies were included for final analysis.Results:Our analysis included749purulent and303mucoid exacerbations of COPD patients. A total of659purulent sputum samples (88.0%) and157mucoid (51.8%) sputum samples yielded positive results of sputum culture. There existed significant association between sputum purulence and bacterial infection in patients with exacerbations of COPD.(odds ratio (OR)=7.34,95%confidence interval (CI)=5.07-10.62, P<0.00001). Conclusion:Sputum purulence may serve as an indicator of bacterial infection in patients with acute exacerbations of COPD.