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Abstract
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INTRODUCTION: Paroxysmal sympathetic hyperactivity (PSH) is a syndrome of excessive sympathetic activity, mainly occurring in severe traumatic brain injury. However, few studies have reported the actual frequency of PSH and its related risk factors in adult patients with brain injury.
METHODS: We performed this systematic review and meta-analysis to estimate the combined incidence of PSH and the associated risk factors in adult patients with brain injury. This study was registered with PROSPERO international prospective register of systematic reviews (https://www.crd.york. ac.uk/PROSPERO/Identifier: CRD 42021260493), and a systematic search was conducted in the scientific database particularly Embase, PubMed, Web of Science, Cochrane Library, and Google scholar. All identified observational studies regarding the incidence and risk factors of PSH in the adult patient with brain injury were included. Two authors extracted data independently; data were analyzed by STATA Version 16 statistical software.
RESULTS: The search yielded nine studies involving 1643 adult patients. PSH was detected in 438 patients. The combined incidence of PSH in adult brain injury patients was 27.4% (95% CI: 0.190-0.358). The risk factors include patients' age (SMD=-0.592, I(2) =77.5%, 95% CI -1.027- -0.156, P=0.008), traffic accident (OR=1.783, I(2) =18.0%, 95% CI 1.128-2.820, P=0.013), admission GCS score (SMD=-1.097, I(2) =28.3%, 95% CI -1.500- -0.693, P=0.000), hydrocephalus (OR=3.936, I(2) =67.9%, 95% CI 1.144-13.540, P=0.030), and diffuse axonal injury (OR=4.747, I(2) =71.1%, 95% CI: 1.221-18.463, P=0.025) and were significantly associated with the present of PSH after brain injury.
CONCLUSION: PSH occurs in nearly a quarter of the adult patients with brain injury, patient's age, traffic accident, admission GCS score, hydrocephalus, and DAI were risk factors to PSH in adult patients with brain injury. These findings may contribute to novel strategies for early diagnosis and interventions that aid in the rehabilitation of brain injury patients.
Language: en |