Agitation is a common behavioral problem following traumatic brain injury (TBI); however, the precise proportion of patients who experience agitation in the early stages of recovery is unknown. The aim of this systematic review and meta-analysis was to evaluate the prevalence of agitation in TBI patients undergoing inpatient care, and whether this prevalence differed by post-traumatic amnesia (PTA) status and setting (acute and rehabilitation). We also aimed to describe the prevalence of sub-types of agitated behavior (disinhibited, aggressive, and emotionally labile). We searched five databases and one clinical trials register, with additional review of websites and key journals to identify any relevant records up to July 2020. We included studies describing the proportion of hospitalized TBI patients age 16 years or older demonstrating agitated behavior. We included comparative studies with and without concurrent controls, randomized controlled trials, pseudo-randomized controlled trials, and case series. Methodological quality was critically appraised using a Joanna Briggs Institute checklist. Sixteen studies met eligibility criteria, with a total of 5592 participants. The pooled prevalence of agitation was 31.73% (95% confidence interval [CI], 25.25%-39.00%) during inpatient care (acute and rehabilitation), 32.23% (95% CI, 27.13%-37.80%) during rehabilitative care and 44.06% (95% CI, 36.15%-52.28%) for inpatients in PTA specifically. Disinhibited behaviors were the most common. There was substantial heterogeneity between studies. Additional high-quality research featuring large samples, frequent and long-term measurement of agitation, use of validated scales, and consideration of variables such as PTA status will further improve estimates of agitation prevalence following TBI.

中文翻译：

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创伤性脑损伤后的激动行为：对创伤后遗忘状态、医院环境和激动行为类型的患病率进行系统回顾和荟萃分析

躁动是创伤性脑损伤 (TBI) 后常见的行为问题；然而，在康复的早期阶段经历激动的患者的确切比例尚不清楚。这项系统评价和荟萃分析的目的是评估接受住院治疗的 TBI 患者的躁动患病率，以及这种患病率是否因创伤后健忘症 (PTA) 状态和环境（急性和康复）而异。我们还旨在描述激动行为亚型（去抑制、攻击性和情绪不稳定）的普遍性。我们检索了 5 个数据库和 1 个临床试验注册库，并对网站和主要期刊进行了额外审查，以确定截至 2020 年 7 月的任何相关记录。我们纳入的研究描述了 16 岁或以上的住院 TBI 患者表现出激动行为的比例。我们纳入了有和没有同时对照的比较研究、随机对照试验、伪随机对照试验和病例系列。使用 Joanna Briggs 研究所检查表对方法学质量进行了严格评估。16 项研究符合资格标准，共有 5592 名参与者。住院治疗（急性和康复）期间躁动的汇总患病率为 31.73%（95% 置信区间 [CI]，25.25%-39.00%），康复治疗期间为 32.23%（95% CI，27.13%-37.80%）和 44.06 % (95% CI, 36.15%-52.28%) 特别适用于 PTA 住院患者。去抑制行为是最常见的。研究之间存在很大的异质性。