Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, Gansu 730000, China.
The First People's Hospital of Yunnan Province, Kunming, China.
J Affect Disord. 2022 Mar 1;300:349-357. doi: 10.1016/j.jad.2022.01.024. Epub 2022 Jan 4.
Suicidality is common among patients with traumatic brain injury (TBI). This meta-analysis aimed to assess the prevalence of suicidal ideation (SI) and suicide attempt (SA) in TBI patients.
Databases including PubMed, Cochrane Library, Embase, CINAHL, Web of Science, PsycINFO, China National Knowledge Infrastructure (CNKI), VIP, WanFang Data, and Chinese Biomedical Literature Database (CBM) were searched for relevant literature from inception to 9th January 2021. Random effects models were used to estimate the prevalence of SI and SA. The methodological quality of the included studies was assessed using the modified Newcastle-Ottawa Scale. Subgroup analysis was performed based on the geographical location of the institutions.
A total of 16 studies involving 1,146,271 patients with TBI were included in our meta-analysis. The prevalence of SI and SA were 19.1% (95% CI 13.6-24.6%) and 2.1% (95% CI 1.8-2.4%), respectively, while the prevalence of SA in Asian and non-Asian countries were 2.0% (95% CI 0.3-3.7%) and 2.0% (95% CI 1.6-2.3%). Meta-regression analyses revealed that the publication year and age were positively associated, while the geographical location of the institution and sample size were negatively associated with the pooled prevalence of SI. On the other hand, the geographical location of the institution, sample size and age were negatively associated with the pooled prevalence of SA.
The overall heterogeneity between studies was high.
SI and SA are common among TBI patients. Therefore, targeted preventive measures are paramount to manage TBI-related suicide.
创伤性脑损伤（TBI）患者中自杀行为较为常见。本荟萃分析旨在评估 TBI 患者自杀意念（SI）和自杀企图（SA）的发生率。
检索 PubMed、Cochrane 图书馆、Embase、CINAHL、Web of Science、PsycINFO、中国知网（CNKI）、维普、万方数据和中国生物医学文献数据库（CBM），收集自成立至 2021 年 1 月 9 日的相关文献。采用随机效应模型估计 SI 和 SA 的发生率。采用改良的 Newcastle-Ottawa 量表评估纳入研究的方法学质量。根据机构的地理位置进行亚组分析。
本荟萃分析共纳入 16 项研究，涉及 1146271 例 TBI 患者。SI 和 SA 的发生率分别为 19.1%（95%CI 13.6-24.6%）和 2.1%（95%CI 1.8-2.4%），而亚洲和非亚洲国家 SA 的发生率分别为 2.0%（95%CI 0.3-3.7%）和 2.0%（95%CI 1.6-2.3%）。Meta 回归分析显示，发表年份和年龄与 SI 的合并发生率呈正相关，而机构地理位置和样本量与 SI 的合并发生率呈负相关。另一方面，机构地理位置、样本量和年龄与 SA 的合并发生率呈负相关。
各研究间总体异质性较高。
SI 和 SA 在 TBI 患者中较为常见。因此，针对 TBI 相关自杀行为，采取有针对性的预防措施至关重要。
