Dynamic Prevalence of and Factors Associated with Fatigue Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Observational Studies

I. Hsing Liu, Chia Jou Lin, Debby Syahru Romadlon, Shu Chun Lee, Hui Chung Huang, Pin Yuan Chen, Hsiao Yean Chiu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Objective: To implement a systematic review and meta-Analysis to comprehensively synthesize the prevalence of and factors associated with fatigue following traumatic brain injury (TBI). Methods: We systematically searched the PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, and ProQuest Dissertations and Theses A&I databases in all fields from their inception to March 31, 2021. We included observational studies investigating fatigue at specific time points following TBI or factors associated with post-TBI fatigue. All data were analyzed using a random-effects model. Results: This meta-Analysis included 29 studies that involved 12 662 patients with TBI and estimated the prevalence of post-TBI fatigue (mean age = 41.09 years); the meta-Analysis also included 23 studies that involved 6681 patients (mean age = 39.95 years) and investigated factors associated with post-TBI fatigue. In patients with mild-To-severe TBI, the fatigue prevalence rates at 2 weeks or less, 1 to 3 months, 6 months, 1 year, and 2 years or more after TBI were 52.2%, 34.6%, 36.0%, 36.1%, and 48.8%, respectively. Depression (r = 0.48), anxiety (r = 0.49), sleep disturbance (r = 0.57), and pain (r = 0.46) were significantly associated with post-TBI fatigue. No publication bias was identified among the studies, except for those assessing fatigue prevalence at 6 months after TBI. Conclusion: The pooled prevalence rates of post-TBI fatigue exhibited a U-shaped pattern, with the lowest prevalence rates occurring at 1 to 3 months after TBI. Depression, anxiety, sleep disturbance, and pain were associated with post-TBI fatigue. Younger patients and male patients were more likely to experience post-TBI fatigue. Our findings can assist healthcare providers with identifying appropriate and effective interventions targeting post-TBI fatigue at specific periods.

Original languageEnglish
Pages (from-to)E172-E181
JournalJournal of Head Trauma Rehabilitation
Volume39
Issue number4
DOIs
StatePublished - 20 10 2023
Externally publishedYes

Bibliographical note

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • associated factors
  • fatigue
  • meta-Analysis
  • prevalence
  • traumatic brain injury
  • Prevalence
  • Fatigue/epidemiology
  • Humans
  • Risk Factors
  • Brain Injuries, Traumatic/complications
  • Observational Studies as Topic

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