脑卒中后发作患者的结果:系统性审查和元分析
Shubham Misra1, Scott E Kasner2, Jesse Dawson3
1Division of Stroke & Vascular Neurology, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut.
JAMA neurology
|September 18, 2023
概括
脑卒中后发作 (PSSs) 在中风幸存者中显著增加死亡率和残疾. 特别是早期发作与较高的死亡率有关,这凸显了预防发作研究的必要性.
科学领域:
- 神经学 神经学
- 临床研究 临床研究
- 公共卫生 公共卫生
背景情况:
- 关于中风后发作 (PSSs) 对患者结局的影响存在不一致的数据.
- 需要对PSS对中风患者结果的影响进行系统评估.
研究的目的:
- 调查和比较PSS患者与没有PSS患者的结果.
- 系统地评估PSS对中风患者结果的影响.
主要方法:
- 一个系统的审查和对报告PSS结果的观察性研究的元分析.
- 在多个数据库 (MEDLINE,Embase等) 进行了搜索. 从1951年开始到2023年1月.
- 使用PRISMA检查清单和Joanna Briggs研究所的数据提取和偏差风险评估工具;使用随机效应元分析分析数据.
主要成果:
- 包括71篇文章,超过20,000名患有PSS的患者和100多万没有PSS的患者.
- PSS与增加的死亡率 (OR,2.1),较差的功能结果 (OR,2.2),较大的残疾 (SMD,0.6) 和痴呆风险 (OR,3.1) 有关.
- 早期发作与较高的死亡率和不良结果有关,影响了缺血性和出血性中风亚型.
结论:
- 脑卒中后发作与中风患者的死亡率增加和严重残疾显著相关.
- 对这些关联的进一步研究是临床和研究的优先事项.
- 可能需要进行临床试验,研究预防中风后发作的干预措施.
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