Citation

Phyland R, Ponsford J, Carrier S, Hicks A, McKay A. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2021.0257

PMID

unavailable

Abstract

Agitation is a common behavioural problem following traumatic brain injury (TBI), however the precise proportion of patients who experience agitation in the early stages of recovery is unknown. The aim of this systematic review and meta-analysis was to evaluate the prevalence of agitation in TBI patients undergoing inpatient care, and whether this prevalence differed by post-traumatic amnesia (PTA) status and setting (acute and rehabilitation). We also aimed to describe the prevalence of sub-types of agitated behaviour (disinhibited, aggressive and emotionally labile). We searched five databases and one clinical trials register, with additional review of websites and key journals to identify any relevant records up to July 2020. We included studies describing the proportion of hospitalised TBI patients aged 16 years or older demonstrating agitated behaviour. We included comparative studies with and without concurrent controls, randomised controlled trials, pseudorandomised controlled trials and case series.

METHODological quality was critically appraised using a Joanna Briggs Institute checklist. Sixteen studies met eligibility criteria, with a total of 5592 participants. The pooled prevalence of agitation was 31.73% (95%CI, 25.25%-39.00%) during inpatient care (acute and rehabilitation), 32.23% (95% CI, 27.13%-37.80%) during rehabilitative care and 44.06% (95% CI, 36.15%-52.28%) for inpatients in PTA specifically. Disinhibited behaviours were the most common. There was substantial heterogeneity between studies. Additional high-quality research featuring large samples, frequent and long-term measurement of agitation, use of validated scales and consideration of variables such as PTA status will further improve estimates of agitation prevalence following TBI. PROSPERO Registration: CRD42020201604. Funding: No funding to declare.

Language: en

Keywords

Behavior; TRAUMATIC BRAIN INJURY; NEUROPSYCHOLOGY; BEHAVIORAL ASSESSMENTS; HEAD TRAUMA