创伤性脑损伤后疲劳的动态患病率及其相关因素：一项观察性研究的系统评价和荟萃分析。
Dynamic Prevalence of and Factors Associated With Fatigue Following Traumatic Brain Injury: A Systematic Review and Meta-analysis of Observational Studies.
机构信息
Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan (Ms Liu); School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan (Mss Liu and Lin and Drs Romadlon, Huang, and Chiu); Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand (Dr Romadlon); School of Gerontology and Long Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan (Dr Lee); Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan, and School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (Dr Chen); and Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, and Department of Nursing, Taipei Medical University Hospital, Taipei, and Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan (Dr Chiu).
出版信息
J Head Trauma Rehabil. 2024;39(4):E172-E181. doi: 10.1097/HTR.0000000000000904. Epub 2023 Oct 20.
OBJECTIVE
To implement a systematic review and meta-analysis to comprehensively synthesize the prevalence of and factors associated with fatigue following traumatic brain injury (TBI).
METHODS
We systematically searched the PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, and ProQuest Dissertations and Theses A&I databases in all fields from their inception to March 31, 2021. We included observational studies investigating fatigue at specific time points following TBI or factors associated with post-TBI fatigue. All data were analyzed using a random-effects model.
RESULTS
This meta-analysis included 29 studies that involved 12 662 patients with TBI and estimated the prevalence of post-TBI fatigue (mean age = 41.09 years); the meta-analysis also included 23 studies that involved 6681 patients (mean age = 39.95 years) and investigated factors associated with post-TBI fatigue. In patients with mild-to-severe TBI, the fatigue prevalence rates at 2 weeks or less, 1 to 3 months, 6 months, 1 year, and 2 years or more after TBI were 52.2%, 34.6%, 36.0%, 36.1%, and 48.8%, respectively. Depression ( r = 0.48), anxiety ( r = 0.49), sleep disturbance ( r = 0.57), and pain ( r = 0.46) were significantly associated with post-TBI fatigue. No publication bias was identified among the studies, except for those assessing fatigue prevalence at 6 months after TBI.
CONCLUSION
The pooled prevalence rates of post-TBI fatigue exhibited a U-shaped pattern, with the lowest prevalence rates occurring at 1 to 3 months after TBI. Depression, anxiety, sleep disturbance, and pain were associated with post-TBI fatigue. Younger patients and male patients were more likely to experience post-TBI fatigue. Our findings can assist healthcare providers with identifying appropriate and effective interventions targeting post-TBI fatigue at specific periods.
目的
系统评价和荟萃分析综合评估创伤性脑损伤（TBI）后疲劳的发生率和相关因素。
方法
我们系统地检索了 PubMed、EMBASE、Cochrane 图书馆、护理和联合健康文献累积索引、PsycINFO 和 ProQuest 学位论文和综合索引数据库中所有字段的文献，检索时间从建库至 2021 年 3 月 31 日。纳入研究为特定时间点 TBI 后疲劳或与 TBI 后疲劳相关因素的观察性研究。所有数据均采用随机效应模型进行分析。
结果
本荟萃分析纳入了 29 项研究，共涉及 12662 例 TBI 患者，估计 TBI 后疲劳的发生率（平均年龄为 41.09 岁）；还纳入了 23 项研究，共涉及 6681 例患者（平均年龄为 39.95 岁），调查了与 TBI 后疲劳相关的因素。在轻至重度 TBI 患者中，TBI 后 2 周或更短时间、1-3 个月、6 个月、1 年和 2 年或更长时间的疲劳发生率分别为 52.2%、34.6%、36.0%、36.1%和 48.8%。抑郁（ r = 0.48）、焦虑（ r = 0.49）、睡眠障碍（ r = 0.57）和疼痛（ r = 0.46）与 TBI 后疲劳显著相关。除了评估 TBI 后 6 个月疲劳发生率的研究外，其他研究均未发现发表偏倚。
结论
TBI 后疲劳的累积发生率呈 U 型模式，TBI 后 1-3 个月时发生率最低。抑郁、焦虑、睡眠障碍和疼痛与 TBI 后疲劳有关。年轻患者和男性患者更容易发生 TBI 后疲劳。我们的研究结果可以帮助医疗保健提供者在特定时期识别针对 TBI 后疲劳的适当和有效干预措施。
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