Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review.
Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review.
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成人创伤性脑损伤和全因死亡率的合并症：系统评价。
DOI：
10.1136/bmjopen-2019-029072
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发表时间：
2019
期刊：
影响因子：
2.9
通讯作者：
Mollayeva,Tatyana
中科院分区：
文献类型：
--
作者：
Xiong,Chen;Hanafy,Sara;Chan,Vincy;Hu,ZhengJing;Sutton,Mitchell;Escobar,Michael;Colantonio,Angela;Mollayeva,Tatyana
目的创伤性脑损伤（TBI）合并症已被公认为改变患者的临床过程，并影响短期和长期的结果。我们综合了不同共病情况对TBI后早期和晚期死亡率影响的证据，以便（1）检查TBI中共病情况与全因死亡率之间的关系，（2）确定TBI患者基线时社会人口统计学和临床特征对全因死亡率的影响。检索PsycINFO 1997年5月至2019年1月期间的相关文献和参考书目。纳入研究的入选标准符合以下标准：（1）关注与我们感兴趣的成人结局相关的合并症（即，≥18岁）诊断为TBI;（2）通过任何方式（不包括自我报告）检测到合并症;（3）报告了无合并症的参与者比例，以及（4）数据提取和综合两名独立的评审员提取数据，并使用预后研究质量工具评估偏倚风险。数据通过列表和定性描述进行综合。结果共纳入27项队列研究。在广泛的个体共病研究中，只有低血压是TBI后死亡率的一致预测因素。其他一致的预测因素是传统的社会人口学风险因素。较高的合并症量表，分数和合并症的条件的数量并不一致与后TBI mortality.ConclusionsGiven的合并症的条件，检查由单一的研究，研究需要进一步证实的证据，并解决相互矛盾的结果。最后，一套增强的适用于TBI人群的合并症指标将允许更好的风险分层，以指导TBI管理和治疗。PROSPERO注册号CRD 42017070033
ObjectivesComorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.DesignSystematic review.Data sourcesMedline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesisTwo independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.ResultsA total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.ConclusionsGiven the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration numberCRD42017070033