Mohammed Maan Al-Salihi, Maryam Sabah Al-Jebur, Ahmed Abd Elazim, Ram Saha, Ahmed Saleh, Farhan Siddiq, Ali Ayyad, Adnan I Qureshi
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The Comprehensive Meta-Analysis (CMA) software was used for the analysis. Subgroup analyses were conducted based on stroke type, TBI severity, and post-TBI phase. The Newcastle-Ottawa Scale (NOS) was utilized for the quality assessment.</p><p><strong>Results: </strong>We included a total of 13 observational studies, with data from 8 studies used for quantitative analysis. A history of TBI was associated with a significantly higher odds of stroke compared to controls (HR = 2.3, 95% CI (1.79 to 2.958), <i>p</i> < 0.001). The risk was greater for hemorrhagic stroke (HR = 4.8, 95% CI (3.336 to 6.942), <i>p</i> < 0.001) than for ischemic stroke (HR = 1.56, 95% CI (1.28 to 1.9), <i>p</i> < 0.001). Both moderate-to-severe TBI (HR = 3.64, 95% CI (2.158 to 6.142), <i>p</i> < 0.001) and mild TBI (HR = 1.81, 95% CI (1.17 to 2.8), <i>p</i> = 0.007) were associated with a significantly higher risk of stroke. The risk was also higher in the early post-TBI phase (1-30 days) (HR = 4.155, 95% CI (2.25 to 7.67), <i>p</i> < 0.001) compared to later phases (HR = 1.68, 95% CI (1.089 to 2.59), <i>p</i> = 0.019) from 30 days to 1 year and (HR = 1.87, 95% CI (1.375 to 2.544), <i>p</i> < 0.001) after 1 year.</p><p><strong>Conclusions: </strong>This systematic review confirms a significant association between TBI and an increased risk of stroke, regardless of TBI severity, type, or timing of stroke. The findings highlight the need for early monitoring and advocating preventive strategies for stroke in patients with a history of TBI.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"6 1","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944542/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association Between Stroke and Traumatic Brain Injury: A Systematic Review and Meta-Analysis.\",\"authors\":\"Mohammed Maan Al-Salihi, Maryam Sabah Al-Jebur, Ahmed Abd Elazim, Ram Saha, Ahmed Saleh, Farhan Siddiq, Ali Ayyad, Adnan I Qureshi\",\"doi\":\"10.3390/neurosci6010021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Stroke and traumatic brain injury (TBI) represent two major health concerns worldwide. There is growing evidence suggesting a potential association between TBI and stroke. In this systematic review and meta-analysis, we aim to explore the association between TBI and stroke risk, with a specific focus on overall stroke risk and subgroup variations based on stroke type, severity, and the post-TBI time period.</p><p><strong>Methods: </strong>PubMed, Web of Science (WOS), Scopus, and Cochrane Library were systematically searched for studies exploring the link between stroke and TBI. The pooled hazard ratios (HRs) with a 95% confidence interval (CI) were calculated. The Comprehensive Meta-Analysis (CMA) software was used for the analysis. Subgroup analyses were conducted based on stroke type, TBI severity, and post-TBI phase. The Newcastle-Ottawa Scale (NOS) was utilized for the quality assessment.</p><p><strong>Results: </strong>We included a total of 13 observational studies, with data from 8 studies used for quantitative analysis. A history of TBI was associated with a significantly higher odds of stroke compared to controls (HR = 2.3, 95% CI (1.79 to 2.958), <i>p</i> < 0.001). The risk was greater for hemorrhagic stroke (HR = 4.8, 95% CI (3.336 to 6.942), <i>p</i> < 0.001) than for ischemic stroke (HR = 1.56, 95% CI (1.28 to 1.9), <i>p</i> < 0.001). Both moderate-to-severe TBI (HR = 3.64, 95% CI (2.158 to 6.142), <i>p</i> < 0.001) and mild TBI (HR = 1.81, 95% CI (1.17 to 2.8), <i>p</i> = 0.007) were associated with a significantly higher risk of stroke. The risk was also higher in the early post-TBI phase (1-30 days) (HR = 4.155, 95% CI (2.25 to 7.67), <i>p</i> < 0.001) compared to later phases (HR = 1.68, 95% CI (1.089 to 2.59), <i>p</i> = 0.019) from 30 days to 1 year and (HR = 1.87, 95% CI (1.375 to 2.544), <i>p</i> < 0.001) after 1 year.</p><p><strong>Conclusions: </strong>This systematic review confirms a significant association between TBI and an increased risk of stroke, regardless of TBI severity, type, or timing of stroke. 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引用次数: 0
摘要
背景：中风和创伤性脑损伤（TBI）是世界范围内两大健康问题。越来越多的证据表明脑外伤和中风之间存在潜在的联系。在这项系统回顾和荟萃分析中，我们旨在探讨脑外伤与卒中风险之间的关系，特别关注总体卒中风险以及基于卒中类型、严重程度和脑外伤后时间段的亚组差异。方法：系统检索PubMed、Web of Science （WOS）、Scopus和Cochrane Library，检索探讨脑卒中与TBI之间关系的研究。计算具有95%置信区间（CI）的合并风险比（hr）。采用综合meta分析（Comprehensive Meta-Analysis， CMA）软件进行分析。根据脑卒中类型、脑外伤严重程度和脑外伤后阶段进行亚组分析。采用纽卡斯尔-渥太华量表（NOS）进行质量评价。结果：我们共纳入13项观察性研究，其中8项研究的数据用于定量分析。与对照组相比，有脑外伤史的患者发生卒中的几率显著增加（HR = 2.3, 95% CI (1.79 ~ 2.958), p < 0.001）。出血性卒中的风险（HR = 4.8, 95% CI (3.336 ~ 6.942), p < 0.001）高于缺血性卒中（HR = 1.56, 95% CI (1.28 ~ 1.9), p < 0.001）。中度至重度脑外伤（HR = 3.64, 95% CI (2.158 ~ 6.142), p < 0.001）和轻度脑外伤（HR = 1.81, 95% CI (1.17 ~ 2.8), p = 0.007）与卒中风险显著升高相关。tbi后早期阶段（1-30天）（HR = 4.155, 95% CI (2.25 ~ 7.67), p < 0.001）与后期阶段（HR = 1.68, 95% CI (1.089 ~ 2.59), p = 0.019）和1年后（HR = 1.87, 95% CI (1.375 ~ 2.544), p < 0.001）相比，风险也更高。结论：该系统综述证实了脑外伤与卒中风险增加之间的显著关联，无论脑外伤的严重程度、类型或卒中时间如何。研究结果强调了对有脑外伤史的患者进行早期监测和提倡卒中预防策略的必要性。
Association Between Stroke and Traumatic Brain Injury: A Systematic Review and Meta-Analysis.
Background: Stroke and traumatic brain injury (TBI) represent two major health concerns worldwide. There is growing evidence suggesting a potential association between TBI and stroke. In this systematic review and meta-analysis, we aim to explore the association between TBI and stroke risk, with a specific focus on overall stroke risk and subgroup variations based on stroke type, severity, and the post-TBI time period.
Methods: PubMed, Web of Science (WOS), Scopus, and Cochrane Library were systematically searched for studies exploring the link between stroke and TBI. The pooled hazard ratios (HRs) with a 95% confidence interval (CI) were calculated. The Comprehensive Meta-Analysis (CMA) software was used for the analysis. Subgroup analyses were conducted based on stroke type, TBI severity, and post-TBI phase. The Newcastle-Ottawa Scale (NOS) was utilized for the quality assessment.
Results: We included a total of 13 observational studies, with data from 8 studies used for quantitative analysis. A history of TBI was associated with a significantly higher odds of stroke compared to controls (HR = 2.3, 95% CI (1.79 to 2.958), p < 0.001). The risk was greater for hemorrhagic stroke (HR = 4.8, 95% CI (3.336 to 6.942), p < 0.001) than for ischemic stroke (HR = 1.56, 95% CI (1.28 to 1.9), p < 0.001). Both moderate-to-severe TBI (HR = 3.64, 95% CI (2.158 to 6.142), p < 0.001) and mild TBI (HR = 1.81, 95% CI (1.17 to 2.8), p = 0.007) were associated with a significantly higher risk of stroke. The risk was also higher in the early post-TBI phase (1-30 days) (HR = 4.155, 95% CI (2.25 to 7.67), p < 0.001) compared to later phases (HR = 1.68, 95% CI (1.089 to 2.59), p = 0.019) from 30 days to 1 year and (HR = 1.87, 95% CI (1.375 to 2.544), p < 0.001) after 1 year.
Conclusions: This systematic review confirms a significant association between TBI and an increased risk of stroke, regardless of TBI severity, type, or timing of stroke. The findings highlight the need for early monitoring and advocating preventive strategies for stroke in patients with a history of TBI.
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