Systematic review of self-reported prognosis in adults after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
Systematic review of self-reported prognosis in adults after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
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DOI：
10.1016/j.apmr.2013.08.299
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发表时间：
2014-03-01
影响因子：
4.3
通讯作者：
Borg, Jorgen
中科院分区：
文献类型：
--
作者：
Cassidy, J David;Cancelliere, Carol;Borg, Jorgen
目的：资料来源：计算机检索MEDLINE、PsycINFO、Embase、CINAHL、SPORTDiscus，检索时间为2001/2012。研究选择：对照试验和队列研究和病例对照研究根据预先确定的标准进行选择。研究必须评估主观的、自我报告的结果。在筛选了77，914篇标题和摘要后，299篇文章合格并进行了科学质量审查。这包括3个原始的MTBI预后国际合作（ICoMP）research study.DATA EXTRACTION：合格的研究进行了严格的评估，使用苏格兰校际指南网络标准。两名评审员独立审查了每项研究，并从接受的文章中列出数据。第三个审查员进行了咨询disagreements.DATA SYNTHESIS：证据从接受的研究定性合成为关键的发现，和预后信息的优先顺序根据设计的探索性或验证性。在299项回顾性研究中，101项（34%）被接受，并形成了我们预后研究的证据基础。其中，23项涉及成人自我报告的结局，包括3项原始ICoMP研究中的2项。这些研究表明，常见的脑震荡后症状并不特定于MTBI/脑震荡，也发生在其他损伤后。MTBI后恢复不佳与病前精神和身体健康状况较差以及与更多损伤相关的压力有关。大多数恢复超过1年，但持续的症状更有可能在那些更急性的症状和更多的情绪stress.CONCLUSIONS：常见的主观症状后MTBI不一定是脑损伤本身引起的，但他们可以在某些患者中持续。那些最初抱怨和心理困扰较多的人恢复得较慢。我们需要对这些问题进行更多高质量的研究。
OBJECTIVE: To update the mild traumatic brain injury (MTBI) prognosis review published by the World Health Organization Task Force in 2004.DATA SOURCES: MEDLINE, PsycINFO, Embase, CINAHL, and SPORTDiscus were searched from 2001 to 2012. We included published, peer-reviewed studies with more than 30 adult cases.STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess subjective, self-reported outcomes. After 77,914 titles and abstracts were screened, 299 articles were eligible and reviewed for scientific quality. This includes 3 original International Collaboration on MTBI Prognosis (ICoMP) research studies.DATA EXTRACTION: Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed each study and tabled data from accepted articles. A third reviewer was consulted for disagreements.DATA SYNTHESIS: Evidence from accepted studies was synthesized qualitatively into key findings, and prognostic information was prioritized according to design as exploratory or confirmatory. Of 299 reviewed studies, 101 (34%) were accepted and form our evidence base of prognostic studies. Of these, 23 addressed self-reported outcomes in adults, including 2 of the 3 original ICoMP research studies. These studies show that common postconcussion symptoms are not specific to MTBI/concussion and occur after other injuries as well. Poor recovery after MTBI is associated with poorer premorbid mental and physical health status and with more injury-related stress. Most recover over 1 year, but persistent symptoms are more likely in those with more acute symptoms and more emotional stress.CONCLUSIONS: Common subjective symptoms after MTBI are not necessarily caused by brain injury per se, but they can be persistent in some patients. Those with more initial complaints and psychological distress recover slower. We need more high-quality research on these issues.