Comorbidity in traumatic brain injury and functional outcomes: a systematic review.
Comorbidity in traumatic brain injury and functional outcomes: a systematic review.
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DOI：
10.23736/s1973-9087.21.06491-1
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发表时间：
2021-08
影响因子：
4.5
通讯作者：
Mollayeva, Tatyana
中科院分区：
文献类型：
--
作者：
Hanafy, Sara;Xiong, Chen;Chan, Vincy;Sutton, Mitchell;Escobar, Michael;Colantonio, Angela;Mollayeva, Tatyana
创伤性脑损伤（TBI）患者的合并症可能会对损伤恢复过程产生负面影响，并导致长期残疾。尽管TBI中多种合并症的患病率很高，但人们对它们与患者功能结局的关系知之甚少。我们的目的是系统地回顾目前的证据，以确定影响TBI成人功能结局的合并症。系统检索Medline、科克伦对照试验中心、Embase和PsycINFO中1997 - 2020年以英文发表的前瞻性和回顾性纵向研究。三名研究人员独立筛选和评估符合纳入标准的文章。质量评估遵循预后研究质量工具和苏格兰校际指南网络方法建议。22项中等质量的研究讨论了合并症对TBI患者功能结局的影响。认知和身体功能受到合并症的负面影响，虽然协会的强度，即使在同一类别的合并症和功能结果，不同的研究。TBI的严重程度、性别和年龄是影响这种关系的重要因素。由于研究之间的方法学异质性，未进行荟萃分析。新出现的证据强调了合并症对TBI患者功能结局的不良影响，因此临床对该主题的关注是及时的。未来的研究应该强调合并症的发病时间与TBI事件的关系，以支持预防，治疗和康复。PROSPERO注册（CRD 42017070033）。
Comorbidities in people with traumatic brain injury (TBI) may negatively impact injury recovery course and result in long-term disability. Despite the high prevalence of several categories of comorbidities in TBI, little is known about their association with patients’ functional outcomes. We aimed to systematically review the current evidence to identify comorbidities that affect functional outcomes in adults with TBI. A systematic search of Medline, Cochrane Central Register of Controlled Trials, Embase and PsycINFO was conducted from 1997 to 2020 for prospective and retrospective longitudinal studies published in English. Three researchers independently screened and assessed articles for fulfillment of the inclusion criteria. Quality assessment followed the Quality in Prognosis Studies tool and the Scottish Intercollegiate Guidelines Network methodology recommendations. Twenty-two studies of moderate quality discussed effects of comorbidities on functional outcomes of patients with TBI. Cognitive and physical functioning were negatively affected by comorbidities, although the strength of association, even within the same categories of comorbidity and functional outcome, differed from study to study. Severity of TBI, sex/gender, and age were important factors in the relationship. Due to methodological heterogeneity between studies, meta-analyses were not performed. Emerging evidence highlights the adverse effect of comorbidities on functional outcome in patients with TBI, so clinical attention to this topic is timely. Future research on the topic should emphasize time of comorbidity onset in relation to the TBI event, to support prevention, treatment, and rehabilitation. PROSPERO registration (CRD 42017070033).