骨折联络服务对脆性骨折患者干预效果的系统评价

A systematic analysis of the intervention effect of fracture liaison services on patients with fragility frac⁃tures

目的系统评价骨折联络服务(FLS)在脆性骨折患者中的应用效果。方法检索PubMed、Web of Sci-ence、中国知网、万方和维普数据库中2014年1月1日—2023年12月30日关于FLS对脆性骨折患者进行干预的相关文献。采用偏倚风险评估工具2.0和渥太华评价量表分别对随机对照研究和观察性研究进行偏倚风险评价和质量评价。最后,基于数据质量评估,使用RevMan5.4分析软件进行Meta分析。结果本研究共纳入24篇文献,总计18558例脆性骨折患者。Meta分析结果显示,FLS可以缓解脆性骨折患者的疼痛(SMD=-1.25,95%CI:-1.39~-1.12,P<0.05)、降低二次骨折发生率(RR=0.60,95%CI:0.48~0.75,P<0.05)、减少病死率(RR=0.86,95%CI:0.80~0.93,P<0.05)、提高骨质疏松确诊率(RR=2.24,95%CI:1.74~2.87,P<0.05)、改善生活质量(SMD=10.34,95%CI:7.26~13.42,P<0.05)。结论FLS有助缓解脆性骨折患者的疼痛,降低二次骨折风险,减少病死率,提高脆性骨折患者骨质疏松的确诊率,提升患者的整体生活质量。

Objective A systematic analysis was performed to evaluate the efficacy of fracture liaison services(FLS)in patients with fragility fractures.Methods Literature related to FLS intervention in fragility fracture patients was searched from PubMed,Web of Science,CNKI,Wanfang and VIP databases from January 1,2014 to December 30,2023.The Bias Risk Assessment Tool 2.0 and the Ottawa Assessment Scale were used to evaluate the risk of bias in ran-domized controlled studies and observational studies.Finally,based on data quality assessment,meta-analysis was per-formed using Review Manager 5.4 analysis software.Results A total of 18558 patients with fragility fractures were in-cluded in 24 studies.Meta-analysis results showed that FLS can relieve pain in patients with fragility fractures(SMD=-1.25,95%CI:-1.39--1.12,P<0.05),reduce the incidence of secondary fractures(RR=0.60,95%CI:0.48-0.75,P<0.05),reduce mortality(RR=0.86,95%CI:0.80-0.93,P<0.05),increase the diagnosis rate of osteoporosis(RR=2.24,95%CI:1.74-2.87,P<0.05),and improve quality of life(SMD=10.34,95%CI:7.26-13.42,P<0.05).Con-clusion FLS can help relieve pain in patients with fragility fractures,reduce the risk of secondary fractures,reduce mor-tality,increase the diagnosis rate of osteoporosis in patients with fragility fractures,and improve the overall quality of life of patients.