Xing Dan, Xu Yuankun, Liu Qiang, Ke Yan, Wang Bin, Li Zhichang, Lin Jianhao
Arthritis Clinic &Research Center, Peking University People's Hospital, Peking University, Beijing, China.
Sci Rep. 2016 Apr 18;6:24393. doi: 10.1038/srep24393.
The objective of this study is to investigate the association between osteoarthritis (OA) and all-cause mortality in worldwide populations and to develop recommendations according to GRADE evidence levels. Literature search through Nov 2015 was performed using the electronic databases (including MEDLINE, EMBASE, EBSCO and Cochrane library). The prospective cohort trials that investigated the association between the symptomatic OA (SxOA) or radiological OA (ROA) and all-cause mortality were identified. Hazard ratios (HR) of all-cause mortality in patients with RxOA or ROA were pooled respectively. The evidence quality was evaluated using the GRADE system, while the recommendations were taken according to the quality. Nine of the published literature met the eligible criteria. Meta-analysis revealed that there was no significant difference in the association between SxOA and all-cause mortality (HR = 0.91, 95% CI: 0.68-1.23) and between ROA and all-cause mortality (HR = 1.13, 95% CI: 0.95-1.35). The overall GARDE evidence quality was very low, which will lower our confidence in taking recommendations. To summarize, there was no reliable and confident evidence existed currently in respect of the association between OA and all-cause mortality. Due to the very low level of evidence quality currently, high-quality studies are still required.
本研究的目的是调查全球人群中骨关节炎（OA）与全因死亡率之间的关联，并根据GRADE证据水平制定建议。通过电子数据库（包括MEDLINE、EMBASE、EBSCO和Cochrane图书馆）对截至2015年11月的文献进行检索。确定了调查症状性骨关节炎（SxOA）或放射学骨关节炎（ROA）与全因死亡率之间关联的前瞻性队列试验。分别汇总了RxOA或ROA患者全因死亡率的风险比（HR）。使用GRADE系统评估证据质量，并根据质量提出建议。9篇已发表文献符合纳入标准。荟萃分析显示，SxOA与全因死亡率之间的关联（HR = 0.91，95%CI：0.68 - 1.23）以及ROA与全因死亡率之间的关联（HR = 1.13，95%CI：0.95 - 1.35）均无显著差异。总体GARDE证据质量非常低，这会降低我们对采纳建议的信心。总之，目前关于OA与全因死亡率之间关联尚无可靠且有把握的证据。由于目前证据质量水平极低，仍需要高质量的研究。
