BACKGROUND AND PURPOSE An estimated 2.5-3.1% of people with episodic migraine develop chronic migraine in a year. Several risk factors are associated with an increased risk for this transformation. We conducted a systematic review and meta-analysis to provide quantitative and qualitative data on predictors of this transformation. METHODS An electronic search was conducted for published, prospective, cohort studies that reported risk factors for chronic migraine among people with episodic migraine. Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. Quality of evidence was determined according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. Effect estimates were retrieved and summarized using risk ratios. RESULTS Of 5695 identified publications, 11 were eligible for inclusion. The pooled analysis (GRADE system) found "high" evidence for monthly headache day frequency ≥ 10 (risk ratio = 5.95), "moderate" evidence for depression (risk ratio = 1.58), monthly headache day frequency ≥ 5 (risk ratio = 3.18), and annual household income ≥ $50,000 (risk ratio = 0.65) and "very low" evidence for allodynia (risk ratio = 1.40) and medication overuse (risk ratio = 8.82) in predicting progression to chronic migraine. CONCLUSIONS High frequency episodic migraine and depression have high quality evidence as predictors of the transformation from episodic migraine to chronic migraine, while annual household income over $50,000 may be protective.

中文翻译：

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发作性偏头痛转变为慢性偏头痛的预测因素：观察性队列研究的系统评价和荟萃分析。

背景和目的估计有 2.5-3.1% 的发作性偏头痛患者在一年内发展为慢性偏头痛。若干风险因素与这种转变的风险增加有关。我们进行了系统回顾和荟萃分析，以提供有关这种转变预测因素的定量和定性数据。方法 对已发表的前瞻性队列研究进行了电子搜索，这些研究报告了发作性偏头痛患者慢性偏头痛的危险因素。使用纽卡斯尔-渥太华质量评估量表评估偏倚风险。根据推荐分级评估、制定和评估 (GRADE) 指南确定证据质量。使用风险比检索和总结效果估计值。结果 在确定的 5695 篇出版物中，有 11 篇符合纳入条件。汇总分析（GRADE 系统）发现每月头痛日频率 ≥ 10 的“高”证据（风险比 = 5.95）、抑郁症的“中等”证据（风险比 = 1.58）、每月头痛日频率 ≥ 5（风险比 = 3.18） )，家庭年收入 ≥ 50,000 美元（风险比 = 0.65），异常性疼痛（风险比 = 1.40）和药物过度使用（风险比 = 8.82）在预测慢性偏头痛进展方面的证据“非常低”。结论 高频发作性偏头痛和抑郁症具有高质量的证据，可作为从发作性偏头痛向慢性偏头痛转变的预测因子，而家庭年收入超过 50,000 美元可能具有保护作用。抑郁症（风险比 = 1.58）、每月头痛日频率≥ 5（风险比 = 3.18）、家庭年收入≥ 50,000 美元（风险比 = 0.65）和异常性疼痛的“非常低”证据（风险比 = 1.40）和药物过度使用（风险比 = 8.82）预测进展为慢性偏头痛。结论 高频发作性偏头痛和抑郁症具有高质量的证据，可作为从发作性偏头痛向慢性偏头痛转变的预测因子，而家庭年收入超过 50,000 美元可能具有保护作用。抑郁症（风险比 = 1.58）、每月头痛日频率≥ 5（风险比 = 3.18）、家庭年收入≥ 50,000 美元（风险比 = 0.65）和异常性疼痛的“非常低”证据（风险比 = 1.40）和药物过度使用（风险比 = 8.82）预测进展为慢性偏头痛。结论 高频发作性偏头痛和抑郁症具有高质量的证据，可作为从发作性偏头痛向慢性偏头痛转变的预测因子，而家庭年收入超过 50,000 美元可能具有保护作用。