脑卒中病人居家相关危险因素的Meta分析

Risk factors of family care of patients with stroke:a Meta-analysis

目的:探讨脑卒中病人居家相关危险因素。方法:计算机检索The Cochrane Library、PubMed、Web of Science、EMbase、中国知网、万方数据库、维普数据库和中国生物医学文献数据库等数据库中关于脑卒中病人居家相关危险因素的文献,检索时限为建库至2020年3月2日,由2位研究者筛选文献、提取资料,并进行质量评价。利用RevMan 5.3软件进行Meta分析。结果:共纳入21篇文献,分析结果显示,女性[OR=2.64,95%CI(1.64,4.26),Z=3.99,P<0.0001]、年龄≥40岁[OR=1.54,95%CI(1.24,1.90),Z=3.98,P<0.0001]、兄弟姐妹有脑卒中病史[OR=1.85,95%CI(1.27,2.71),Z=3.18,P=0.001]、子女配偶护理[OR=1.97,95%CI(1.13,3.44),Z=2.40,P=0.02]是脑卒中病人居家相关危险因素,家庭佣工护理是脑卒中病人居家相关保护因素[OR=0.49,95%CI(0.33,0.72),Z=3.60,P=0.0003],脑卒中后14~30 d的Barthel指数评分≤14分是脑卒中病人居家相关危险因素[OR=1.86,95%CI(1.39,2.50),Z=4.14,P<0.0001],低体质指数、收入低是脑卒中病人居家相关危险因素(P<0.05)。结论:现有证据表明,女性、年龄≥40岁、兄弟姐妹有脑卒中病史、子女配偶护理、脑卒中后14~30 d的Barthel指数评分≤14分、低体质指数、收入低是脑卒中病人居家相关危险因素,家庭佣工护理是脑卒中病人居家相关保护因素。但受纳入研究数量和质量限制,结论尚需开展更多高质量研究予以验证。

Objective:To explore the risk factors of family care of patients with stroke.Methods:Researches on risk factors of family care of patients with stroke were retrieved from The Cochrane Library,PubMed,Web of Science,EMbase,CNKI,Wanfang Database,VIP,CBM and so on.The retrieval period was from the establishment of databases to 2 March,2020.The literature screening,data extraction and quality evaluation were completed by two researchers.And RevMan 5.3 software was used for Meta-analysis.Results:A total of 21 literatures were included.The analysis results showed that female was the risk factors of family care of patients with stroke[OR=2.64,95%CI(1.64,4.26),Z=3.99,P<0.0001],age≥40 years old was the risk factors of family care of patients with stroke[OR=1.54,95%CI(1.24,1.90),Z=3.98,P<0.0001],sibling with a history of stroke was the risk factors of family care of patients with stroke[OR=1.85,95%CI(1.27,2.71),Z=3.18,P=0.001],care of children and spouse was the risk factors of family care of patients with stroke[OR=1.97,95%CI(1.13,3.44),Z=2.40,P=0.02],domestic helper care was the protection factor of family care of patients with stroke[OR=0.49,95%CI(0.33,0.72),Z=3.60,P=0.0003],score of Barthel Index≤14 from 14 to 30 days after stroke was the risk factors of family care of patients with stroke[OR=1.86,95%CI(1.39,2.50),Z=4.14,P<0.0001],low body mass index was the risk factors of family care of patients with stroke(P<0.05),and low income was the risk factors of family care of patients with stroke(P<0.05).Conclusions:Existing evidence showed that female,age≥40 years old,sibling with a history of stroke,care of children and spouse,score of Barthel Index≤14 from 14 to 30 days after stroke,low body mass index,and low income were risk factors related to family care of patients with stroke.And domestic helper care was the protection factor of family care of patients with stroke.However,limited by the number and quality of literatures,the conclusions still need to be verified by more high-quality studies.