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A systematic review and meta-analysis of independent risk factors for postherpetic neuralgia
Haiou Zhou1, Zhiguang Wang1, Haifei Jin1
1Department of Anesthesiology, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University School of Medicine, Jiaxing, China.
Background:
This study aimed to explore the independent risk factors for postherpetic neuralgia (PHN).
Methods:
Related studies of PHN risk factors were searched in PubMed for screening and meta-analysis. In this study, data from studies included were extracted and summarized, including odds ratio (OR) value, 95% confidence interval (CI), P value, sample size, and the number of patients with and without PHN. The chi-square test was used for heterogeneity test. Sensitivity analysis was conducted by excluding low-quality studies and using different model analysis.
Results:
A total of 14 studies were further screened for meta-analysis, including 4,192 patients with herpes zoster. Of these patients, 478 (11.40%) had neuralgia and 3,714 (88.60%) did not have neuralgia. Age [OR =1.59; 95% CI: (1.23, 2.04); Z=3.62; P<0.001], acute severe pain in the herpes stage [OR =1.49; 95% CI: (1.08, 2.08); Z=2.39; P=0.02], prodromal symptoms [OR =2.00; 95% CI: (1.16, 3.44); Z=2.48; P=0.01], and severe rash [OR =2.40; 95% CI: (1.83, 3.14); Z=6.38; P<0.001] were independent risk factors for PHN. The funnel chart shows that there is no publication bias or geographic bias in the above independent risk factors. Gender (Z=0.37; P=0.71) was not associated with PHN, and the funnel chart shows that there is no publication bias or geographic bias.
Discussion:
Age, acute pain, prodromal symptoms, and severe rash were independent risk factors for PHN.
