Stroke risk following traumatic brain injury: Systematic review and meta-analysis (original) (raw)
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The International Incidence of Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 2016
Background: Understanding the epidemiology of traumatic brain injury (TBI) is essential to shape public health policy, implement prevention strategies, and justify allocation of resources toward research, education, and rehabilitation in TBI. There is not, to our knowledge, a systematic review of population-based studies addressing the epidemiology of TBI that includes all subtypes. We performed a comprehensive systematic review and meta-analysis of the worldwide incidence of TBI. Methods: A search was conducted on May 23, 2014, in Medline and EMBASE according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Abstracts were screened independently and in duplicate to identify original research. Study quality and ascertainment bias were assessed in duplicate using a previously published tool. Demographic data and incidence estimates from each study were recorded, along with stratification by age, gender, year of data collection, and severity. Results: T...
Traumatic Brain Injury as a Risk Factor for Stroke
2017
TBI is a potential unrecognized stroke risk factor as trauma to the head and neck may increase stroke risk through vascular dissection, (5) microvascular injury, or abnormal coagulation. The aim of the study is to evaluate whether traumatic brain injury may be a risk factor for subsequent ischemic stroke. This study used data of patients presented in Emergency Department in University Hospital Trauma of Tirana from 2012 to 1 December 2015. A total number of 1524 patients were presented in ED. The study cohort included 1524 total trauma subjects, 611 (40.1%) with TBI. The median duration of follow-up was 28 months (interquartile range 14–44), with a total of 18 (1.2%) ischemic strokes identified during this timeframe: 1.8% in the TBI group and 1.3% in the non-TBI trauma group. By having regular medical checkups and knowing the risk, one can focus on what can change and lower the risk of stroke.
Risk and Mortality of Traumatic Brain Injury in Stroke Patients
Journal of Head Trauma Rehabilitation, 2014
Objective: Patients with stroke had higher incidence of falls and hip fractures. However, the risk of traumatic brain injury (TBI) and post-TBI mortality in patients with stroke was not well defined. Our study is to investigate the risk of TBI and post-TBI mortality in patients with stroke. Methods: Using reimbursement claims from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study of 7622 patients with stroke and 30 488 participants without stroke aged 20 years and older as reference group. Data were collected on newly developed TBI after stroke with 5 to 8 years' follow-up during 2000 to 2008. Another nested cohort study including 7034 hospitalized patients with TBI was also conducted to analyze the contribution of stroke to post-TBI in-hospital mortality. Results: Compared with the nonstroke cohort, the adjusted hazard ratio of TBI risk among patients with stroke was 2.80 (95% confidence interval = 2.58-3.04) during the follow-up period. Patients with stroke had higher mortality after TBI than those without stroke (10.2% vs 3.2%, P < .0001) with an adjusted relative risk (RR) of 1.46 (95% confidence interval = 1.15-1.84). Recurrent stroke (RR = 1.60), hemorrhagic stroke (RR = 1.68), high medical expenditure for stroke (RR = 1.80), epilepsy (RR = 1.79), neurosurgery (RR = 1.94), and hip fracture (RR = 2.11) were all associated with significantly higher post-TBI mortality among patients with stroke. Conclusions: Patients with stroke have an increased risk of TBI and in-hospital mortality after TBI. Various characteristics of stroke severity were all associated with higher post-TBI mortality. Special attention is needed to prevent TBI among these populations.
Predictive Factors and the Role of Traumatic Brain Injury in Stroke
2018
Background: Traumatic brain injury (TBI) is the leading cause of mortality and invalidity worldwide. Objective: To explore whether traumatic brain injury may be a risk factor for subsequent stroke and to evaluate the role of other risk factors correlated with TBI and stroke. Methods: We analysed 643 patients presented in the emergency department of Trauma UHC, from 1 st of June 2011-1 st of December 2011. We evaluated the following factors: age, gender, and severity of head trauma, type of head trauma, systemic hypertension, atrial fibrillation, and diabetes mellitus. Results: During 1-year of follow upperiod 32 (4.97%) strokes occurred in TBI patients. The evaluation was done in correlation with the other risk factors taken into account in the study. conclusions: The role of TBI is underestimated in the evaluation of stroke. This study demonstrated that during the first year after TBI, 13.53 % of patients experienced stroke. After careful statistical correlations with the selected co-morbidities, we found that the diagnosis of stroke was strongly related with TBI.
Prevalence of Traumatic Brain Injury in the General Adult Population: A Meta-Analysis
Neuroepidemiology, 2013
An estimated 1.5-2 million people sustain a traumatic brain injury (TBI) every year in the USA alone [1] , where TBIs account for approximately 1.4 million emergency room visits, 275,000 hospital admissions, and 52,000 deaths each year [2]. The resultant personal and social costs are high, with some estimates suggesting that costs associated with TBI are between 9 and 10 billion dollars annually [1]. While incidence rates for TBI are readily available, there is comparatively little information about the prevalence of TBI in the general population. TBI presents several unique issues when attempting to estimate prevalence. One problem in estimating the prevalence of TBI is the amorphous nature of head injury: TBI diagnosis can range from mild to severe, with signs and symptoms varying across and within severity levels. Further, the distinction between mild and moderate and moderate and severe TBI is often unclear. A second area of concern is that multiple methods are used to diagnose TBI severity, including Glasgow Coma Scale (GCS) scores, length of posttraumatic amnesia (PTA), and presence or absence of loss of consciousness (LOC) at the time of injury [3]. The definitional and diagnostic ambiguity surrounding TBI results in inconsistent reports about incidence rates and residual effects of TBI [4]. Finally, TBI is associated with specific subgroups of the population-the young,
Systematic Reviews in the Practice of the Epidemiology of Traumatic Brain Injuries
Scientific Journal of Polonia University, 2019
High quality epidemiological data are vital for planning effective public health preventive strategies, providing health care services and evaluation of their effectiveness. Systematic reviews provide a summary of the results of carefully selected studies in a methodologically defined reproducible process. Authors of this article will present their experiences with the living systematic review of the epidemiology of traumatic brain injuries in Europe developed within the international project CENTER-TBI using the standardized methods.
Actual data on epidemiological evolution and prevention endeavours regarding traumatic brain injury
Journal of Medicine and Life, 2015
Background: Knowledge of the epidemiology of traumatic brain injury (TBI) is required both to prevent this disorder and to develop effective care and rehabilitation approaches for patients. Objective: The aim of this article is to find solutions to decrease the incidence of TBI and offer recommendations for their prevention. Material and methods: We analyzed epidemiological studies on TBI by performing a systematic review of literature, using information reported by different centers, collecting data on demographics, showing characteristics of TBI including incidence, identification of risk groups on differences in age, gender, geographical variation, severity and mortality. Results: Studies suggest that the incidence of TBI is between 18 and 250 per 100,000 persons per year. Men and people living in social and economical deprived areas, usually young adults and the elderly are high-risk groups for TBI. Discussion: Prevention remains the “key point” in medicine and especially for TB...
Systematic reviews, 2015
Traumatic brain injury (TBI) is a leading cause of death and disability around the world. Management based on Brain Trauma Foundation (BTF) guidelines is widely accepted and thought to improve outcome. The objectives of this systematic review are to give an overview of adherence to the BTF guidelines, describe factors influencing adherence, and study the effect of guideline-based management on outcome. We will search electronic bibliographic databases: PROSPERO, Medline, EMBASE, SCOPUS, NHS, CINAHL, Cochrane Database, and ProQuest Dissertations and Theses Global. Two investigators will independently screen all titles, abstracts, and articles and select Randomized Controlled Trial (RCT), cohort studies, case-control studies, and case series reporting the adherence rate, factors influencing adherence, and mortality or morbidity. These investigators will also independently extract data using a pre-designed and pilot-tested standardized electronic data extraction form and assess the ris...
Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review
BMJ Open
ObjectivesComorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.DesignSystematic review.Data sourcesMedline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants wit...