Pearson R G, Clement R G E, Edwards K L, Scammell B E
Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
BMJ Open. 2016 Nov 14;6(11):e010303. doi: 10.1136/bmjopen-2015-010303.
Systematic review and meta-analysis of published observational cohort studies. To quantify the increased risk smokers have of experiencing a delayed and/or non-union in fractures, spinal fusion, osteotomy, arthrodesis or established non-unions.
Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Allied and Complementary Medicine Database (AMED) and Web of Science Core Collection from 1966 to 2015.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: Observational cohort studies that reported adult smokers and non-smokers with delayed and/or non-union or time to union of the fracture, spinal fusion, osteotomy, arthrodesis or established non-union were eligible.
2 authors screen titles, abstracts and full papers. Data were extracted by 1 author and checked independently by a second. The relative risk ratios of smoking versus non-smoking and the mean difference in time to union patients developing a delayed and/or non-union were calculated.
The search identified 3013 articles; of which, 40 studies were included. The meta-analysis of 7516 procedures revealed that smoking is linked to an increased risk of delayed and/or non-union. When considered collectively, smokers have 2.2 (1.9 to 2.6) times the risk of experiencing delayed and/or non-union. In all the subgroups, the increased risk was always ≥1.6 times that of non-smokers. In the patients where union did occur, it was a longer process in the smokers. The data from 923 procedures were included and revealed an increase in time to union of 27.7 days (14.2 to 41.3).
Smokers have twice the risk of experiencing a non-union after fracture, spinal fusion, osteotomy, arthrodesis or treatment of non-union. Time to union following fracture, osteotomy, arthrodesis or treatment of an established non-union is longer in smokers. Smokers should be encouraged to abstain from smoking to improve the outcome of these orthopaedic treatments.
对已发表的观察性队列研究进行系统评价和荟萃分析。量化吸烟者在骨折、脊柱融合、截骨术、关节融合或已存在的骨不连中出现延迟愈合和/或骨不连的风险增加情况。
1966年至2015年的医学文献分析和检索系统在线数据库（MEDLINE）、医学文摘数据库（EMBASE）、补充和替代医学数据库（AMED）以及科学引文索引核心合集。
研究入选标准、参与者和干预措施：报告成年吸烟者和非吸烟者发生延迟愈合和/或骨不连情况，或骨折、脊柱融合、截骨术、关节融合或已存在的骨不连愈合时间的观察性队列研究符合要求。
两名作者筛选标题、摘要和全文。由一名作者提取数据，并由另一名作者独立检查。计算吸烟与不吸烟的相对风险比以及发生延迟愈合和/或骨不连患者的愈合时间平均差异。
检索到3013篇文章；其中，纳入了40项研究。对7516例手术的荟萃分析表明，吸烟与延迟愈合和/或骨不连风险增加有关。总体来看，吸烟者发生延迟愈合和/或骨不连的风险是不吸烟者的2.2（1.9至2.6）倍。在所有亚组中，风险增加始终≥非吸烟者的1.6倍。在确实发生愈合的患者中，吸烟者的愈合过程更长。纳入了923例手术的数据，结果显示愈合时间增加了27.7天（14.2至41.3天）。
吸烟者在骨折、脊柱融合、截骨术、关节融合或骨不连治疗后发生骨不连的风险是不吸烟者的两倍。骨折、截骨术、关节融合或已存在的骨不连治疗后的愈合时间，吸烟者更长。应鼓励吸烟者戒烟，以改善这些骨科治疗的效果。
Zotero 插件
