Sui Songtao, Sun Jinbo, Chen Xiqi, Fan Feng
Departments of Neurosurgery (Messrs Sui and Chen) and Pharmacy (Ms Fan), Qingdao West Coast New Area Central Hospital, Qingdao, Shandong Province, China; and Department of Neurology, Central Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China (Mr Sun).
J Head Trauma Rehabil. 2023;38(4):E289-E298. doi: 10.1097/HTR.0000000000000818. Epub 2022 Nov 3.
Limited evidence has explored the impact of traumatic brain injury (TBI) on posttraumatic epilepsy with control cohort for comparison. In addition, we could not find any review to identify the effect of TBI on the outcomes. Thus, we conducted this study to compare the risk of epilepsy between individuals with TBI and without TBI.
Systematic and comprehensive search was carried out in the following databases and search engines: EMBASE, Cochrane, MEDLINE, ScienceDirect, and Google Scholar from 1954 until January 2022. The Newcastle Ottawa (NO) Scale was utilized to assess the risk of bias. Meta-analysis was carried out using the random-effects model, and pooled odds ratio (OR) along with 95% CI was reported.
In total, we included 10 studies satisfying inclusion criteria. Most studies had good to satisfactory quality. The pooled OR was 4.25 (95% CI, 1.77-10.25; I2 = 100%), indicating that the individuals with TBI had 4.25 times higher risk of having epilepsy than individuals without TBI, and this association was statistically significant ( P = .001). Subgroup analysis based on the years of follow-up revealed that the patients within 5 years post-TBI had the highest risk of epilepsy (pooled OR = 7.27; 95% CI, 3.61-14.64).
Individuals with TBI had a significantly higher risk of epilepsy than the individuals without TBI, irrespective of the duration of the injury. Hence, long-term follow-up of the individuals with TBI is necessary to prevent any adverse consequences.
仅有有限的证据探讨了创伤性脑损伤(TBI)对创伤后癫痫的影响,并与对照组进行了比较。此外,我们未能找到任何综述来确定TBI对结局的影响。因此,我们开展了这项研究,以比较TBI患者和非TBI患者患癫痫的风险。
在以下数据库和搜索引擎中进行了系统全面的检索:EMBASE、Cochrane、MEDLINE、ScienceDirect以及谷歌学术,检索时间跨度从1954年至2022年1月。采用纽卡斯尔渥太华(NO)量表评估偏倚风险。使用随机效应模型进行荟萃分析,并报告合并比值比(OR)及95%置信区间(CI)。
我们总共纳入了10项符合纳入标准的研究。大多数研究质量良好至令人满意。合并OR为4.25(95%CI,1.77 - 10.25;I² = 100%),表明TBI患者患癫痫的风险是非TBI患者的4.25倍,且这种关联具有统计学意义(P = .001)。基于随访年限的亚组分析显示,TBI后5年内的患者癫痫风险最高(合并OR = 7.27;95%CI,3.61 - 14.64)。
无论损伤持续时间如何,TBI患者患癫痫的风险均显著高于非TBI患者。因此,对TBI患者进行长期随访对于预防任何不良后果是必要的。