认知储备与中风结果的关联:系统性审查和元分析
Laura Gallucci1,2, Mirjam R Heldner1, Christoph Sperber1
1Department of Neurology, University hospital, Inselspital, University of Bern, Bern, Switzerland.
概括
认知储备 (CR) 显著影响中风的结果,较低的CR与较差的恢复有关. 了解教育和职业等CR代理可以改善临床和研究环境中的中风结果预测.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 认知储备 (CR) 解释了对神经退行性病理的功能反应的个体差异.
- 脑卒中结果的变化需要了解影响康复的因素.
研究的目的:
- 评估认知储备 (CR) 和中风结果之间的关联.
- 为了提高预测中风恢复的个体间变异性.
主要方法:
- 按照PRISMA和MOOSE指导方针对同行评审研究进行系统审查和元分析.
- 包括评估CR代理 (教育,职业) 和中风结果 (NIHSS,mRS,BI,FIM) 的研究.
- 偏差风险评估使用QUIPS和随机效应模型进行元分析.
主要成果:
- 对10项研究 (19,308名患者) 的分析显示,低CR与中风的不良结果相关 (SMD,0.23).
- 教育水平 (SMD,0.37) 和职业成就 (SMD,0.34) 与中风结局的关联比教育年数 (SMD,0.01) 更强.
- 与慢性阶段相比,急性-次急性中风阶段 (≤3个月) 中CR的影响更为明显.
结论:
- 认知储备 (CR) 解释了中风结果的个体间变异性,提高了预测准确性.
- 低CR增加了不良中风结果的风险;在临床实践和研究中应考虑CR代理.
- 由于观察到的研究异质性,需要进一步的研究来探索超越教育和职业的其他CR代理.
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