scholarly journals Prevalence of uterine rupture among women with one prior low transverse cesarean and women with unscarred uterus undergoing labor induction with PGE2: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253957
Author(s):  
Giuseppe Chiossi ◽  
Roberto D’Amico ◽  
Anna L. Tramontano ◽  
Veronica Sampogna ◽  
Viola Laghi ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Meta Analysis ◽  
Rare Event ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Cochrane Library ◽  
Cesarean Birth ◽  
Pooled Prevalence ◽  
Arcsine Transformation ◽  
The Cochrane Library

Background As uterine rupture may affect as many as 11/1000 women with 1 prior cesarean birth and 5/10.000 women with unscarred uterus undergoing labor induction, we intended to estimate the prevalence of such rare outcome when PGE2 is used for cervical ripening and labor induction. Methods We searched MEDLINE, ClinicalTrials.gov and the Cochrane library up to September 1st 2020. Retrospective and prospective cohort studies, as well as randomized controlled trials (RCTs) on singleton viable pregnancies receiving PGE2 for cervical ripening and labor induction were reviewed. Prevalence of uterine rupture was meta-analyzed with Freeman-Tukey double arcsine transformation among women with 1 prior low transverse cesarean section and women with unscarred uterus. Results We reviewed 956 full text articles to include 69 studies. The pooled prevalence rate of uterine rupture is estimated to range between 2 and 9 out of 1000 women with 1 prior low transverse cesarean (5/1000; 95%CI 2-9/1000, 122/9000). The prevalence of uterine rupture among women with unscarred uterus is extremely low, reaching at most 0.7/100.000 (<1/100.000.000; 95%CI <1/100.000.000–0.7/100.000, 8/17.684). Conclusions Uterine rupture is a rare event during cervical ripening and labor induction with PGE2.

scholarly journals The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis of 12 011 447 individuals

2021 ◽  
Author(s):  
Tawanda Chivese ◽  
Joshua T. Matizanadzo ◽  
Omran A. H. Musa ◽  
George Hindy ◽  
Luis Furuya-Kanamori ◽  
...  
Keyword(s):  
B Cells ◽  
Meta Analysis ◽  
Synthesis Method ◽  
Immunological Memory ◽  
Cochrane Library ◽  
Binary Outcomes ◽  
Pooled Prevalence ◽  
Previous Infection ◽  
Arcsine Transformation ◽  
The Cochrane Library

AbstractObjectivesThis study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 specific antibodies as well as memory T and B cells after recovery. In addition, the prevalence of COVID-19 reinfection, and the preventive efficacy of previous infection with SARS-CoV-2 were investigated.Methods and analysesA synthesis of existing research was conducted. The Cochrane Library for COVID-19 resources, the China Academic Journals Full Text Database, PubMed, and Scopus as well as preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. We included studies with the relevant outcomes of interest. All included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity between included studies was assessed using the I2 and Cochran’s Q statistics and publication bias was assessed using Doi plots.ResultsFifty-four studies, from 18 countries, with a total of 12 011 447 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of detectable SARS-CoV-2 specific immunological memory remained high; IgG – 90.4% (95%CI 72.2-99.9, I2=89.0%, 5 studies), CD4+ - 91.7% (95%CI 78.2 – 97.1, one study), and memory B cells 80.6% (95%CI 65.0-90.2, one study) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0 – 0.7, I2 = 98.8, 9 studies). Individuals who recovered from COVID-19 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1 - 0.3, I2 = 90.5%, 5 studies).ConclusionAround 90% of people previously infected with SARS-CoV-2 had evidence of immunological memory to SARS-CoV-2, which was sustained for at least 6-8 months after recovery, and had a low risk of reinfection.RegistrationPROSPERO: CRD42020201234

scholarly journals Transfer of pathogens to and from patients, healthcare providers, and medical devices during care activity—a systematic review and meta-analysis

2018 ◽  
Vol 39 (9) ◽  
pp. 1093-1107 ◽  
Author(s):  
Aline Wolfensberger ◽  
Lauren Clack ◽  
Stefan P. Kuster ◽  
Simone Passerini ◽  
Lona Mody ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medical Devices ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Hospital Environment ◽  
Cochrane Library ◽  
Systematic Research ◽  
Arcsine Transformation ◽  
The Cochrane Library

AbstractObjectiveThe transfer of pathogens may spread antimicrobial resistance and lead to healthcare-acquired infections. We performed a systematic literature review to generate estimates of pathogen transfer in relation to healthcare provider (HCP) activities.MethodsFor this systematic review and meta-analysis, Medline/Ovid, EMBASE, and the Cochrane Library were searched for studies published before July 7, 2017. We reviewed the literature, examining transfer of pathogens associated with HCP activities. We included studies that (1) quantified transfer of pathogens from a defined origin to a defined destination surface; (2) reported a microbiological sampling technique; and (3) described the associated activity leading to transfer. For studies reporting transfer frequencies, we extracted data and calculated the estimated proportion using Freeman-Tukey double arcsine transformation and the DerSimonian-Laird random-effects model.ResultsOf 13,121 identified articles, 32 were included. Most articles (n=27, 84%) examined transfer from patients and their environment to HCP hands, gloves, and gowns, with an estimated proportion for transfer frequency of 33% (95% confidence interval [CI], 12%–57%), 30% (95% CI, 23%–38%) and 10% (95% CI, 6%–14%), respectively. Other articles addressed transfer involving the hospital environment and medical devices. Risk factor analyses in 12 studies suggested higher transfer frequencies after contact with moist body sites (n=7), longer duration of care (n=5), and care of patients with an invasive device (n=3).ConclusionsRecognizing the heterogeneity in study designs, the available evidence suggests that pathogen transfer to HCPs occurs frequently. More systematic research is urgently warranted to support targeted and economic prevention policies and interventions.

scholarly journals Prevalence of post-traumatic stress symptoms among people influenced by coronavirus disease 2019 outbreak: A meta-analysis

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Dan Qiu ◽  
Yilu Li ◽  
Ling Li ◽  
Jun He ◽  
Feiyun Ouyang ◽  
...  
Keyword(s):  
Sample Size ◽  
Traumatic Stress ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Pooled Prevalence ◽  
Registration Number ◽  
Post Traumatic ◽  
The Cochrane Library

Abstract Background As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from coronavirus disease 2019 (COVID-19) outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak. Methods Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticle, and Chinese National Knowledge Infrastructure until October 14, 2020. Statistical analyses were performed using R software (PROSPERO registration number: CRD42020180309). Results A total of 106,713 people exposed to the trauma resulting from the COVID-19 outbreak were identified in the 76 articles, of which 33,810 were reported with post-traumatic stress symptoms. The pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak was 28.34%, with a 95% confidence interval of 23.03-34.32%. Subgroup analysis indicated that older age, male and bigger sample size were associated with higher prevalence of post-traumatic stress symptoms. After controlling for other factors, the results of meta-regression showed that the influence of gender and sample size on prevalence is no longer significant. Conclusions Symptoms of post-traumatic stress disorder (PTSD) were very common among people exposed to the trauma resulting from COVID-19 outbreak. Further research is needed to explore more possible risk factors for post-traumatic stress symptoms and identify effective strategies for preventing PTSD-related symptoms among people exposed to the trauma resulting from COVID-19 outbreak.

Cervical Ripening Using Foley Balloon with or without Oxytocin: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 36 (04) ◽  
pp. 406-421 ◽  
Author(s):  
Lauren Gallagher ◽  
Benjamin Gardner ◽  
Mahbubur Rahman ◽  
Corina Schoen ◽  
Katherine Connolly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cervical Ripening ◽  
Cochrane Library ◽  
Search Terms ◽  
Vaginal Deliveries ◽  
Mechanical Methods ◽  
Multiparous Women ◽  
The Cochrane Library

Objective To assess available evidence regarding the use of oxytocin in conjunction with Foley balloon (FB) for cervical ripening. Methods Databases from MEDLINE (U.S. National Library of Medicine, 1980—May 12, 2017), MEDLINE (Ovid, 1980—June 30, 2017), the Cochrane Library Controlled Trials Register, ClinicalTrials.gov, and Web of Science were queried for studies on FB cervical ripening with or without oxytocin in pregnant women. Search terms included: “balloon dilatation” OR “mechanical methods” OR “mechanical method” OR “mechanical dilation” OR “mechanical dilatation” OR “mechanical dilations” OR “mechanical dilatations” OR “balloon” OR “Foley” AND “Pitocin” OR “oxytocin.” All relevant references were reviewed. Literature for inclusion and methodological quality were reviewed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Results Out of 344 citations, six randomized clinical trials (1,133 patients) fulfilled our inclusion criteria. The pooled estimate showed that the cesarean delivery (CD) rate did not differ (relative risk [RR]: 0.91 (95% confidence interval [CI] [0.76–1.10]; p = 0.23) between patients who underwent preinduction cervical ripening with FB alone versus those who received oxytocin in addition to FB. Heterogeneity was not significant among studies (I 2 0.0%; p = 0.64). Furthermore, no differences in other outcomes such as composite and maternal outcomes were detected between these two groups. Compared with simultaneous use of oxytocin with FB, the Foley alone cervical ripening group had a longer induction to delivery time, and lower deliveries within 12 and 24 hours. Subgroup analysis showed that only multiparous women in the Foley alone group had lower rate of vaginal delivery within 24 hours (RR: 0.74, 95% CI [0.61–0.89], p = 0.002) along with a trend toward higher CD rates. Conclusion Adding oxytocin to FB at the time of preinduction cervical ripening does not reduce cesarean rates nor improve maternal or neonatal outcomes. Multiparous women who received FB alone seem to have lower rates of vaginal deliveries within 24 hours, but these results should be interpreted with caution.

scholarly journals Prevalence of Sleep Disturbances and Sleep Quality in Chinese Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Xia ◽  
Changhao Chen ◽  
Zhiqiang Liu ◽  
Xiangfen Luo ◽  
Chunyan Guo ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Healthcare Workers ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Assessment Instruments ◽  
Knowledge Infrastructure ◽  
Pooled Prevalence ◽  
The Cochrane Library ◽  
Chinese National Knowledge Infrastructure

Objectives: Healthcare workers (HWs) experienced high levels of work stress during the COVID-19 pandemic, leading to a high risk of sleep disturbances. This meta-analysis aimed to explore the prevalence of sleep disturbances and sleep quality in Chinese HWs during the COVID-19 pandemic.Methods: English (PubMed, EMBASE, PsycINFO, Web of Science, and the Cochrane Library) and Chinese databases (WanFang, Chinese National Knowledge Infrastructure, and SinoMed) were systematically and independently searched for relevant studies published from December 1, 2019, to May 20, 2020. The pooled prevalence of sleep disturbances and sleep quality were calculated using a random-effects model.Results: A total of 17 studies involving 12,682 Chinese HWs were included in the meta-analysis. The pooled prevalence of sleep disturbances in Chinese HWs was 45.1% (95% CI: 37.2–53.1%). We found that the prevalence of sleep disturbances varied among frontline, infected, and non-frontline HWs (Q = 96.96, p &lt; 0.001); females and males (Q = 9.10, p = 0.003); studies using different assessment instruments (Q = 96.05, p &lt; 0.001); and studies with different sample sizes (Q = 5.77, p = 0.016) and cut-off values (Q = 62.28, p &lt; 0.001). The pooled mean total score of the Pittsburgh Sleep Quality Index (PSQI) was 9.83 (95% CI: 8.61–11.04). HWs in Wuhan had a higher total PSQI score than those in other regions (Q = 9.21, p = 0.002).Conclusion: Sleep disturbances were common in Chinese HWs during the COVID-19 pandemic, particularly in frontline and infected HWs. Our results indicate the heavy mental health burden on HWs during the COVID-19 pandemic in China and can provide other countries with valuable information to assist HWs during the crisis.

scholarly journals Burden of Uterine Rupture and Its Determinant Factors in Ethiopia: A Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Dagne Addisu ◽  
Maru Mekie ◽  
Abenezer Melkie ◽  
Worku Necho
Keyword(s):  
Systematic Review ◽  
Antenatal Care ◽  
Uterine Rupture ◽  
Addis Ababa ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Obstructed Labor ◽  
Pooled Prevalence ◽  
Rural Residency

Background. Uterine rupture is a life-threatening obstetrical emergency, which results in serious undesired maternal and perinatal complications in resource-limited countries, mainly in Ethiopia. The prevalence, determinants, and outcomes of uterine rupture described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence, determinants, and adverse outcomes of uterine rupture in Ethiopia. Methods. Studies were searched from international databases (PubMed/MEDLINE, HINARI, Cochrane library, Google Scholar, and web of science) and Ethiopian universities’ digital libraries (Addis Ababa University, University of Gondar, and Harameya University). All observational studies were included. A total of 15 studies that fulfill the inclusion criteria were included in this meta-analysis. Data were extracted by two reviewers and exported to STATA version 11 for analysis. The I 2 statistics were used to assess heterogeneity across the studies. Publication bias was examined by using Egger’s test and funnel plot. The pooled prevalence of uterine rupture and its outcomes were estimated by using a random effects model. The associations between determinants and uterine rupture were evaluated by using both random and fixed-effect models. Results. In this meta-analysis, a total of 15 studies with 92,394 study participants were involved. The pooled prevalence of uterine rupture was 2.37% in Ethiopia. Obstructed labor ( OR = 3.03 ; 95 % CI = 2.52 , 3.63 ), lack of antenatal care follow-up ( OR = 5.79 ; 95 % CI = 2.47 , 13.61 ), duration of labor > 24 hours ( OR = 3.75 ; 95 % CI = 2.24 , 6.29 ), grand multipara ( OR = 10.79 ; 95 % CI = 4.77 , 24.40 ), and being rural residency ( OR = 7.17 ; 95 % CI = 3.90 , 13.16 ) were significantly associated with uterine rupture. Conclusion. The overall prevalence of uterine rupture was high in Ethiopia. Obstructed labor, lack of antenatal care follow-up, duration of labor > 24 hours, grand multipara, and rural residency were determinants of uterine rupture. This study implies the need to develop plans and policies to improve antenatal care follow-up and labor and delivery management at each level of the health system.

scholarly journals Correlation Between Thyroid Nodules and Metabolic Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chenyu Zhang ◽  
Xiaotong Gao ◽  
Yutong Han ◽  
Weiping Teng ◽  
Zhongyan Shan
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Nodules ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Published Data ◽  
Thyroid Disorder ◽  
Pooled Prevalence ◽  
The Cochrane Library ◽  
The Relationship

ObjectiveThyroid nodules (TNs) are a common thyroid disorder that can be caused by many factors. Several studies have investigated the relationship between TNs and metabolic syndrome (MetS), but the role of sex and age remains controversial. The purpose of this paper was to analyze published data from all relevant studies to reliably estimate the relationship between TNs and MetS.MethodsThirteen articles were included in this study; articles were identified by searching for publications until July 2021 in PubMed, EMBASE, the Cochrane Library and the Web of Science. The outcomes are presented as the summary odds ratio (OR) and 95% confidence interval (CI) and the pooled prevalence and 95% CI.ResultsThe TNs prevalence was significantly higher in MetS patients than in controls (OR 1.88, 95% CI 1.42-2.50, P &lt; 0.0001) and was independent of sex (male: OR 1.53, 95% CI 1.20-1.94, P = 0.0006; female: OR 1.90, 95% CI 1.54-2.33, P &lt; 0.00001; combined: OR 2.06, 95% CI 1.31-3.25, P = 0.002) and age (&lt; 40 years old: OR 1.62, 95% CI 1.39-1.89, P &lt; 0.0001; 40~50 years old: OR 2.14, 95% CI 1.49-3.08, P &lt; 0.0001;50~60 years old: OR 1.50, 95% CI 1.08-2.07, P = 0. 01; 60 years old: OR 1.70, 95% CI 1.36-2.14, P &lt; 0.00001); the pooled TNs prevalence in MetS patients was 45% (95% CI 36-54%). However, it has not yet been considered that MetS is related to TNs in people with iodine deficiency (OR 3.14, 95% CI 0.92-10.73, P = 0.07).ConclusionThe meta-analysis results showed a strong correlation between TNs and MetS. Both male and female patients with MetS had an increased TNs prevalence. In addition, the prevalence was independent of age. However, MetS is not considered to be associated with TNs in iodine-deficient populations.

scholarly journals Clinical interventions that influence vaginal birth after cesarean delivery rates: Systematic Review & Meta-Analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aireen Wingert ◽  
Lisa Hartling ◽  
Meghan Sebastianski ◽  
Cydney Johnson ◽  
Robin Featherstone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Delivery ◽  
Uterine Rupture ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Vaginal Birth After Cesarean ◽  
Clinical Interventions ◽  
Uterine Dehiscence

Abstract Background To systematically review the literature on clinical interventions that influence vaginal birth after cesarean (VBAC) rates. Methods We searched Ovid Medline, Ovid Embase, Wiley Cochrane Library, CINAHL via EBSCOhost; and Ovid PsycINFO. Additional studies were identified by searching for clinical trial records, conference proceedings and dissertations. Limits were applied for language (English and French) and year of publication (1985 to present). Two reviewers independently screened comparative studies (randomized or non-randomized controlled trials, and observational designs) according to a priori eligibility criteria: women with prior cesarean sections; any clinical intervention or exposure intended to increase the VBAC rate; any comparator; and, outcomes reporting VBAC, uterine rupture and uterine dehiscence rates. One reviewer extracted data and a second reviewer verified for accuracy. Meta-analysis was conducted using Mantel-Haenszel (random effects model) relative risks (VBAC rate) and risk differences (uterine rupture and dehiscence). Two reviewers independently conducted methodological quality assessments using the Mixed Methods Appraisal Tool (MMAT). Results Twenty-nine studies (six trials and 23 cohorts) examined different clinical interventions affecting rates of vaginal deliveries among women with a prior cesarean delivery (CD). Methodological quality was good overall for the trials; however, concerns among the cohort studies regarding selection bias, comparability of groups and outcome measurement resulted in higher risk of bias. Interventions for labor induction, with or without cervical ripening, included pharmacologic (oxytocin, prostaglandins, misoprostol, mifepristone, epidural analgesia), non-pharmacologic (membrane sweep, amniotomy, balloon devices), and combined (pharmacologic and non-pharmacologic). Single studies with small sample sizes and event rates contributed to most comparisons, with no clear differences between groups on rates of VBAC, uterine rupture and uterine dehiscence. Conclusions This systematic review evaluated clinical interventions directed at increasing the rate of vaginal delivery among women with a prior CD and found low to very low certainty in the body of evidence for cervical ripening and/or labor induction techniques. There is insufficient high-quality evidence to inform optimal clinical interventions among women attempting a trial of labor after a prior CD.

scholarly journals Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis

Pharmacology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Shan Deng ◽  
Yonghao Yu
Keyword(s):  
Femur Fracture ◽  
Meta Analysis ◽  
Sensory Block ◽  
Cochrane Library ◽  
Rescue Analgesia ◽  
Block Level ◽  
Block Time ◽  
Sedation Scores ◽  
The Difference ◽  
The Cochrane Library

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Patients who received DEX infusion had a significant longer time to rescue analgesia compared with those without DEX coadministration. DEX treatment seemed to reduce the visual analog score; however, the significance did not reach any statistical difference. DEX as an analgesic adjuvant did not reduce the onset of sensory block time, shorten the time to achieve maximum sensory block level, and provide a longer duration of sensory block. The difference in mean sedation scores between 2 groups was not statistically significant. As for adverse effects, DEX therapy significantly increased the rate of hypotension. In conclusion, dexmedetomidine as a local anesthetic adjuvant in femur fracture surgery had a longer duration of rescue analgesia. However, the incidence of hypotension was markedly increased in these patients. It was worth noting that the evidence was of low to moderate quality.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

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