Kao Feng-Chen, Hsu Yao-Chun, Wu Chin-Hsien, Wang Chang-Bi, Tu Yuan-Kun, Liu Pao-Hsin
Department of Orthopaedics, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan.
Big Data Research Center and School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan; Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Acta Orthop Traumatol Turc. 2017 Dec;51(6):459-465. doi: 10.1016/j.aott.2017.10.006. Epub 2017 Oct 31.
The aim of this study was to investigate whether corticosteroid use increases the incidence of repeated PVP or kyphoplasty patients older than 50 years.
This study enrolled the data of 2,753 eligible patients from the Taiwan National Health Insurance Research Database who were exposed to systemic corticosteroids for at least 3 months during the first year preceding the first PVP or kyphoplasty. These steroid users were matched 1:1 in age, sex, and the index date of surgery with non-user controls during the enrollment period. All patients were followed for 1 year after the first PVP or kyphoplasty. The incidence of repeated PVP or kyphoplasty was compared between the steroid users and controls. A Cox proportional hazards model was developed to account for multiple confounding factors.
The number of patients receiving repeated PVP or kyphoplasty was 233 (8.46%) and 205 (7.45%) in the corticosteroid and control groups, respectively. The Cox proportional hazards model revealed no association between corticosteroid use and repeated PVP or kyphoplasty.
Systemic corticosteroid use for longer than 3 months is not associated with repeated PVP or kyphoplasty within one year of surgery in patient older than 50 years old.
Level III, Therapeutic study.
本研究旨在调查使用皮质类固醇激素是否会增加50岁以上接受经皮椎体成形术(PVP)或后凸成形术患者再次接受此类手术的发生率。
本研究纳入了来自台湾国民健康保险研究数据库的2753例符合条件的患者的数据,这些患者在首次接受PVP或后凸成形术之前的第一年中接受全身性皮质类固醇激素治疗至少3个月。在入组期间,将这些使用类固醇激素的患者与未使用类固醇激素的对照者按年龄、性别和手术索引日期进行1:1匹配。所有患者在首次接受PVP或后凸成形术后随访1年。比较类固醇激素使用者和对照组再次接受PVP或后凸成形术的发生率。建立Cox比例风险模型以考虑多种混杂因素。
皮质类固醇激素组和对照组中再次接受PVP或后凸成形术的患者人数分别为233例(8.46%)和205例(7.45%)。Cox比例风险模型显示,使用皮质类固醇激素与再次接受PVP或后凸成形术之间无关联。
对于50岁以上的患者,使用全身性皮质类固醇激素超过3个月与术后1年内再次接受PVP或后凸成形术无关。
三级,治疗性研究。