Hospitalisation and mortality outcomes of patients with comorbid COPD and heart failure: a systematic review protocol

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist in patients. Many studies have explored the short-term and long-term outcomes of patients with comorbid COPD and HF; however, there have been discrepancies in their findings. METHODS AND ANALYSIS: In this systematic review, MEDLINE and Embase will be searched using a prespecified search strategy. Randomised controlled trials and studies conducted in the general population that employ analytical or descriptive (longitudinal or case–control) study designs that report odds ratios (ORs), hazard ratios (HRs), or risk ratios (RRs) of mortality or hospitalisation, comparing patients with comorbid COPD and HF with patients with just COPD, will be selected. Screening by title and abstract, then full-text screening will be conducted by two reviewers. The Population, Exposure, Comparator, Outcomes, Study (PECOS) characteristics framework will be used to systemise the data extraction from selected studies. Study quality will be assessed using an adapted version of the Newcastle-Ottawa risk of bias tool. Data extraction and the risk of bias will also be conducted by two reviewers. Given sufficient homogeneity of selected studies, a meta-analysis will be conducted. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria will be used to assess the quality of cumulative evidence. DISSEMINATION: With this review, we hope to improve the understanding of clinical outcomes of patients with comorbid COPD and HF. We intend to publish the results of our review in a peer-reviewed journal and to present our findings at national and international meetings and conferences. PROSPERO REGISTRATION NUMBER: CRD42018089534