体重与髋部骨折手术后短期和长期死亡率的反比关系：一项荟萃分析。
Inverse relation of body weight with short-term and long-term mortality following hip fracture surgery: a meta-analysis.
机构信息
Department of General Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
出版信息
J Orthop Surg Res. 2022 Apr 26;17(1):249. doi: 10.1186/s13018-022-03131-3.
BACKGROUND
The obesity paradox, which suggests that high body weight is positively associated with survival in some diseases, has not been proven in patients with hip fracture. In this study, meta-analysis of previous studies on the impacts of body weight on postoperative mortality following hip fracture surgery in older adults was conducted.
METHODS
PubMed, Embase, and Cochrane library were searched for studies investigating the correlation between mortality after hip fracture surgery and body weight. The search main items included: ("Body mass index" OR "BMI" or "body weight") and ("hip fracture" or "hip fractures"). Studies contained data on short-term (≤ 30-day) and long-term (≥ 1 year) mortality after hip fracture and its association with distinct body weight or BMI groups were reported as full-text articles were included in this meta-analysis.
RESULTS
Eleven separate studies were included. The definitions of underweight and obesity differed among the included studies, but the majority of the enrolled studies used the average body weight definition of a BMI of 18.5 to 24.9 kg/m; underweight referred to a BMI of < 18.5 kg/m; and obesity pertained to a BMI of > 30 kg/m. Based on the generalized definitions of body-weight groups from the enrolled studies, the group with obesity had lower long-term (odds ratio [OR]: 0.63, 95% CI: 0.50-0.79, P < 0.00001) and short-term (OR: 0.63, 95% CI: 0.58-0.68, P ≤ 0.00001) mortality rates after hip fracture surgery when compared with patients with average-weight group. However, compared with the average-weight group, the underweight group had higher long-term (OR: 1.51, 95% CI: 1.15-1.98, P=0.003) and short-term (OR: 1.49, 95% CI: 1.29-1.72, P<0.00001) mortality rates after hip fracture surgery.
CONCLUSIONS
Current evidence demonstrates an inverse relation of body weight with long-term and short-term mortality after hip fracture surgery in older adults.
背景
肥胖悖论表明，在某些疾病中，高体重与生存呈正相关，但这一结论尚未在髋部骨折患者中得到证实。本研究对既往关于老年人髋部骨折手术后体重对死亡率影响的研究进行了荟萃分析。
方法
在 PubMed、Embase 和 Cochrane 图书馆中检索了研究髋部骨折手术后死亡率与体重之间相关性的文章。搜索的主要项目包括：（“体重指数”或“BMI”或“体重”）和（“髋部骨折”或“髋部骨折”）。研究包含了短期（≤30 天）和长期（≥1 年）髋部骨折后死亡率及其与不同体重或 BMI 组之间关系的数据，并将报告短期和长期死亡率的全文文章纳入本荟萃分析。
结果
共纳入 11 项独立研究。纳入研究中体重不足和肥胖的定义不同，但大多数纳入的研究使用 BMI 为 18.5 至 24.9kg/m 的平均体重定义；体重不足定义为 BMI<18.5kg/m；肥胖定义为 BMI>30kg/m。根据纳入研究中体重分组的广义定义，肥胖组的长期（比值比 [OR]：0.63，95%可信区间：0.50-0.79，P<0.00001）和短期（OR：0.63，95%可信区间：0.58-0.68，P≤0.00001）死亡率均低于平均体重组。然而，与平均体重组相比，体重不足组的长期（OR：1.51，95%可信区间：1.15-1.98，P=0.003）和短期（OR：1.49，95%可信区间：1.29-1.72，P<0.00001）死亡率均更高。
结论
目前的证据表明，老年人髋部骨折手术后体重与长期和短期死亡率呈负相关。
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