School of Pharmacy, Memorial University of Newfoundland, Health Science Centre, St. John's, NL, Canada.
Newfoundland and Labrador Centre for Health Information, St. John's, NL, Canada.
Neurotoxicology. 2017 Jul;61:234-241. doi: 10.1016/j.neuro.2016.03.006. Epub 2016 Mar 19.
Neurotrauma, including traumatic brain injury (TBI) and spinal cord injury (SCI), is a preventable condition that imposes an important burden on the Canadian society. In this study, the current evidence on risk factors for the onset and progression of neurotrauma is systematically reviewed and synthesized. Searches of the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Medline and Medline in Process (via OVID), EMBASE and PsycINFO from inception to February 2013 were conducted to identify relevant systematic reviews and meta-analyses published in English or French. Two referees screened and assessed the quality of the studies using the AMSTAR tool. Thirty-two studies examined at least one risk factor for the onset of neurotrauma. Thirteen studies passed the quality assessment and the majority evaluated the impact of protective equipment in sports. Helmets effectively reduce TBI from bicycling, skiing, snowboarding, ice hockey and motorcycling. There was no evidence of a protective effect of helmets for SCI. No studies contributed evidence on risk factors for the onset of SCI. Of two studies examining risk factors for the progression of neurotrauma, only injury severity was found to be associated with poorer post-injury outcomes. Substantial evidence supports the use of helmets for the prevention of TBI in sports and motorcycling and face shields in ice hockey. Addressing bicycle helmet legislation across Canada may be an effective option for reducing TBI caused by bicycle accidents. Limited evidence on relevant risk factors for spinal cord injuries and neurotrauma progression was available.
神经创伤，包括外伤性脑损伤（TBI）和脊髓损伤（SCI），是一种可预防的疾病，给加拿大社会带来了重要负担。在这项研究中，系统地回顾和综合了当前关于神经创伤发病和进展的危险因素的证据。从开始到 2013 年 2 月，在 Cochrane 系统评价数据库、效果摘要数据库（DARE）、Medline 和 Medline 在处理（通过 OVID）、EMBASE 和 PsycINFO 中进行了搜索，以确定发表在英文或法文的相关系统评价和荟萃分析。两位审稿人使用 AMSTAR 工具筛选和评估研究的质量。32 项研究至少检查了一种神经创伤发病的危险因素。有 13 项研究通过了质量评估，其中大多数评估了运动中防护设备的影响。头盔可有效减少骑自行车、滑雪、单板滑雪、冰球和骑摩托车导致的 TBI。头盔对 SCI 没有保护作用的证据。没有研究提供关于 SCI 发病危险因素的证据。两项研究检查了神经创伤进展的危险因素，只有损伤严重程度与受伤后较差的结果有关。大量证据支持在运动和骑摩托车中使用头盔，在冰球中使用面罩来预防 TBI。在加拿大各地实施自行车头盔法规可能是减少自行车事故引起的 TBI 的有效选择。关于脊髓损伤和神经创伤进展的相关危险因素的证据有限。
