National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan.
Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan.
Medicina (Kaunas). 2021 Nov 11;57(11):1232. doi: 10.3390/medicina57111232.
This article aimed to investigate the risk factors for poststroke complex regional pain syndrome (CRPS). We searched electronic databases including PubMed, Medline, Web of Science, Cochrane Library, and Embase up to 27 October 2021. We enrolled analytical epidemiological studies comprising cohort, case-control, and cross-sectional studies. A quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale for cohort and case-control studies and the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Binary outcomes were reported as odds ratios (ORs), and continuous outcomes were described as standardized mean differences (SMDs) with 95% confidence intervals. For the meta-regression, beta coefficient and value were adopted. We included 21 articles comprising 2225 participants. Individuals with shoulder subluxation and spasticity were found to have higher risks for poststroke CRPS. Spasticity with higher modified Ashworth scale score, lower Brunnstrom hand stage, and inferior Barthel index scores were observed in patients with poststroke CRPS. The pooled incidence proportion in nine articles was 31.7%, and a correlation was found between effect sizes and the ratio of women and the proportion of left hemiparesis. The summarized prevalence in nine cross-sectional studies was 33.1%, and a correlation was observed between prevalence and the subluxation ratio and Brunnstrom stage. Based on our meta-analysis, being female, left hemiparesis, shoulder subluxation, spasticity, a lower Brunnstrom stage of distal upper limb, and an inferior Barthel index are all features for poststroke CRPS. Larger studies with greater statistical power may confirm our findings and clarify some other unknown risk factors for poststroke CRPS.
这篇文章旨在探讨中风后复杂性区域疼痛综合征（CRPS）的危险因素。我们检索了电子数据库，包括 PubMed、Medline、Web of Science、Cochrane 图书馆和 Embase，截至 2021 年 10 月 27 日。我们纳入了包含队列研究、病例对照研究和横断面研究的分析性流行病学研究。使用纽卡斯尔-渥太华质量评估量表对队列和病例对照研究进行质量评估，使用 Joanna Briggs 研究所分析性横断面研究的批判性评估清单对横断面研究进行质量评估。二分类结局以比值比（OR）表示，连续结局以标准化均数差（SMD）和 95%置信区间表示。对于meta 回归，采用了β系数和 值。我们纳入了 21 篇文章，包含 2225 名参与者。肩半脱位和痉挛的个体患中风后 CRPS 的风险较高。患有中风后 CRPS 的患者，痉挛的改良 Ashworth 量表评分较高、Brunnstrom 手阶段较低和 Barthel 指数评分较低。9 篇文章的汇总发生率为 31.7%，发现效应大小与女性比例和左侧偏瘫比例之间存在相关性。9 篇横断面研究的汇总患病率为 33.1%，发现患病率与半脱位比例和 Brunnstrom 阶段之间存在相关性。基于我们的荟萃分析，女性、左侧偏瘫、肩半脱位、痉挛、远端上肢 Brunnstrom 阶段较低和 Barthel 指数较低都是中风后 CRPS 的特征。具有更大统计效力的更大规模研究可能会证实我们的发现，并阐明一些其他未知的中风后 CRPS 危险因素。
