Effectiveness of bundled care in the management of cerebral hemorrhage complicated by pulmonary infection in China: A systematic review and meta-analysis

Objective: Aimed to systematically evaluate the therapeutic and rehabilitative effects of bundled care on patients with cerebral hemorrhage complicated by pulmonary infection in China. Methods: Relevant literature was retrieved from multiple databases and original studies investigated the efficacy of bundled care in managing cerebral hemorrhage complicated by pulmonary infection were included. Data analysis was conducted using Meta-analysis software (RevMan 5.3 and Stata 17.0). The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Sensitivity analysis was performed to evaluate the robustness of the results. Funnel plot, Begg and Egger test were conducted to assess the presence of publication bias. The protocol was registered in PROSPERO (CRD42023475738). Results: Twelve studies involving 1049 patients were included in this meta-analysis. The results showed that bundled care significantly reduced the duration of antibiotic use and pulmonary infection (SMD = -0.77), reduced the duration of tracheal intubation (MD = -5.35), and shortened hospital stay (MD = -6.30). The effective rate of treatment (OR = 8.39), satisfaction degree (OR = 5.65), anxiety (MD = -4.52) and depression scores (MD = -4.38), and quality of life scores (MD = 11.75) were improved after bundled care intervention compared to routine care. Assessment of publication bias showed no significant evidence of publication bias. Conclusions: Bundled care can significantly shorten the duration of illness treatment and hospital stay of patients with cerebral hemorrhage complicated by pulmonary infection, improve treatment effectiveness and satisfaction degree, alleviate anxiety and depression, and promote the improvement of quality of life.