骨关节炎患者使用曲马多与髋部骨折风险的关系：观察性研究的系统回顾和荟萃分析

IF 1.5 Q3 NURSING International Journal of Orthopaedic and Trauma Nursing Pub Date : 2023-12-12 DOI:10.1016/j.ijotn.2023.101078

Mansour Bahardoust , Sepideh Mousavi , Javad Khaje Mozafari , Zahra Deylami Moezi , Meisam Haghmoradi , Pouya Ebrahimi , Homan Alipour , Heeva Rashidi

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引用次数: 0

摘要

目的许多研究报告了曲马多与骨折风险，特别是髋部骨折的矛盾结果。这项系统回顾和荟萃分析研究旨在首次评估曲马多与可待因使用与髋部骨折风险的关系。方法以特定关键词检索spubmed、Scopus、Google Scholar和Web of Science数据库，查找截至2023年5月曲马多使用与骨关节炎患者髋部骨折风险相关的研究。曲马多与可待因继发髋部骨折的风险是根据年龄和性别来估计的。本系统评价是根据PRISMA检查表进行的。采用Cochran’s Q和I2检验评估研究间的异质性。Egger检验用于检验发表偏倚。使用纽卡斯尔-渥太华检查表(NOS)来评估研究的质量。研究结果回顾了1,939,293名参与者的10项研究。大多数参与者是女性。根据研究评估表，大多数研究质量良好。曲马多的使用显著增加髋部骨折的总体风险。(HR: 1.32, 95% CI: 1.14, 1.51, P: 0.001, I2:19.3%)曲马多使用显著增加男性髋部骨折的风险(HR: 1.48, 95% CI: 1.24, 1.73, P: 0.001 I2:35%)和年龄≤65岁(HR: 1.63, 95% CI: 1.45, 1.80, P: 0.001, I2:0%)。结论曲马多的使用明显增加髋部骨折的风险。在65岁以下的男性中，髋部骨折的风险增加更大。

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Association of tramadol use with risk of hip fractures in patients with osteoarthritis: A systematic review and meta-analysis of observational studies

Objective

Many studies have reported conflicting results for the use of tramadol with the risk of fractures, especially hip fractures. This systematic review and meta-analysis study aimed to evaluate the association of tramadol use versus codeine use with the risk of hip fracture for the first time.

Methods

PubMed, Scopus, Google Scholar, and Web of Science databases were searched with specific keywords to find studies that examined the association of tramadol use with hip fracture risk in patients with osteoarthritis up to May 2023. The risk of hip fracture secondary to tramadol versus codeine use was estimated based on age and sex. This systematic review was conducted based on the PRISMA checklist. Heterogeneity between studies was evaluated using Cochran's Q and I2 tests. Egger's test was used to check publication bias. The Newcastle-Ottawa Checklist (NOS) was used to assess the quality of the studies.

Findings

Ten studies with 1,939,293 participants were reviewed. The majority of participants were female. Based on the study evaluation checklist, most studies were of good quality. Tramadol use significantly increases the overall risk of hip fracture. (HR: 1.32, 95% CI: 1.14, 1.51, P: 0.001, I²:19.3%) Tramadol use significantly increases the risk of hip fracture in men (HR: 1.48, 95% CI: 1.24, 1.73, P: 0.001 I²:35%) and age ≤65 years (HR: 1.63, 95% CI: 1.45, 1.80, P: 0.001, I²:0%).