• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

曲马多或可待因治疗后患髋部骨折的风险：一项观察性研究。

Hip Fracture Risk After Treatment with Tramadol or Codeine: An Observational Study.

机构信息

Janssen Research & Development LLC, 920 Route 202, Raritan, NJ, 08869, USA.

Observational Health Data Sciences and Informatics (OHDSI), OHDSI Collaborators, New York, NY, USA.

出版信息

Drug Saf. 2022 Jul;45(7):791-807. doi: 10.1007/s40264-022-01198-9. Epub 2022 Jul 9.

DOI:10.1007/s40264-022-01198-9
PMID:35810265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9296392/
Abstract

INTRODUCTION

Hip fractures among older people are a major public health issue, which can impact quality of life and increase mortality within the year after they occur. A recent observational study found an increased risk of hip fracture in subjects who were new users of tramadol compared with codeine. These drugs have somewhat different indications. Tramadol is indicated for moderate to severe pain and can be used for an extended period; codeine is indicated for mild to moderate pain and cough suppression.

OBJECTIVE

In this observational study, we compared the risk of hip fracture in new users of tramadol or codeine, using multiple databases and analytical methods.

METHODS

Using data from the Clinical Practice Research Datalink and three US claims databases, we compared the risk of hip fracture after exposure to tramadol or codeine in subjects aged 50-89 years. To ensure comparability, large-scale propensity scores were used to adjust for confounding.

RESULTS

We observed a calibrated hazard ratio of 1.10 (95% calibrated confidence interval 0.99-1.21) in the Clinical Practice Research Datalink database, and a pooled estimate across the US databases yielded a calibrated hazard ratio of 1.06 (95% calibrated confidence interval 0.97-1.16).

CONCLUSIONS

Our results did not demonstrate a statistically significant difference between subjects treated for pain with tramadol compared with codeine for the outcome of hip fracture risk.

摘要

简介

老年人髋部骨折是一个主要的公共卫生问题，会影响生活质量，并增加骨折发生后一年内的死亡率。最近的一项观察性研究发现，与可待因相比，曲马多的新使用者发生髋部骨折的风险增加。这些药物的适应证略有不同。曲马多用于治疗中重度疼痛，可长期使用；可待因用于治疗轻中度疼痛和咳嗽抑制。

目的

本观察性研究使用多个数据库和分析方法比较了新使用曲马多或可待因的患者发生髋部骨折的风险。

方法

使用来自临床实践研究数据库和三个美国索赔数据库的数据，我们比较了 50-89 岁患者在暴露于曲马多或可待因后发生髋部骨折的风险。为了确保可比性，我们使用大规模倾向评分来调整混杂因素。

结果

我们在临床实践研究数据库中观察到校准后的风险比为 1.10（95%校准置信区间 0.99-1.21），在美国数据库的汇总估计中得出校准后的风险比为 1.06（95%校准置信区间 0.97-1.16）。

结论

我们的结果并未表明在疼痛治疗中使用曲马多与可待因的患者发生髋部骨折风险的结果存在统计学上的显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/bd773773fabb/40264_2022_1198_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/02ede3964220/40264_2022_1198_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/ad52327df9ef/40264_2022_1198_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/913c5ffd5e2a/40264_2022_1198_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/842ce3cdc87e/40264_2022_1198_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/412f307b7afc/40264_2022_1198_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/91ae53404e41/40264_2022_1198_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/50ce0f72c3d6/40264_2022_1198_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/bd773773fabb/40264_2022_1198_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/02ede3964220/40264_2022_1198_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/ad52327df9ef/40264_2022_1198_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/913c5ffd5e2a/40264_2022_1198_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/842ce3cdc87e/40264_2022_1198_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/412f307b7afc/40264_2022_1198_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/91ae53404e41/40264_2022_1198_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/50ce0f72c3d6/40264_2022_1198_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df9/9296392/bd773773fabb/40264_2022_1198_Fig8_HTML.jpg

相似文献

1
Hip Fracture Risk After Treatment with Tramadol or Codeine: An Observational Study.曲马多或可待因治疗后患髋部骨折的风险：一项观察性研究。
Drug Saf. 2022 Jul;45(7):791-807. doi: 10.1007/s40264-022-01198-9. Epub 2022 Jul 9.
2
Association of Tramadol vs Codeine Prescription Dispensation With Mortality and Other Adverse Clinical Outcomes.曲马多与可待因处方配药与死亡率及其他不良临床结局的关联
JAMA. 2021 Oct 19;326(15):1504-1515. doi: 10.1001/jama.2021.15255.
3
Tramadol for noncancer pain and the risk of hyponatremia.曲马多用于非癌性疼痛及低钠血症风险
Am J Med. 2015 Apr;128(4):418-25.e5. doi: 10.1016/j.amjmed.2014.10.046. Epub 2014 Nov 22.
4
Association of tramadol with all-cause mortality, cardiovascular diseases, venous thromboembolism, and hip fractures among patients with osteoarthritis: a population-based study.曲马多与骨关节炎患者全因死亡率、心血管疾病、静脉血栓栓塞和髋部骨折的相关性：一项基于人群的研究。
Arthritis Res Ther. 2022 Apr 11;24(1):85. doi: 10.1186/s13075-022-02764-3.
5
Association of Tramadol Use With Risk of Hip Fracture.曲马多使用与髋部骨折风险的关联
J Bone Miner Res. 2020 Apr;35(4):631-640. doi: 10.1002/jbmr.3935. Epub 2020 Feb 5.
6
Association of tramadol use with risk of hip fractures in patients with osteoarthritis: A systematic review and meta-analysis of observational studies.曲马多的使用与骨关节炎患者髋部骨折风险的关联：观察性研究的系统评价和荟萃分析。
Int J Orthop Trauma Nurs. 2024 Feb;52:101078. doi: 10.1016/j.ijotn.2023.101078. Epub 2023 Dec 12.
7
Tramadol use and the risk of hospitalization for hypoglycemia in patients with noncancer pain.曲马多的使用与非癌痛患者低血糖住院风险的关系。
JAMA Intern Med. 2015 Feb;175(2):186-93. doi: 10.1001/jamainternmed.2014.6512.
8
Tramadol/acetaminophen combination tablets and codeine/acetaminophen combination capsules for the management of chronic pain: a comparative trial.曲马多/对乙酰氨基酚复方片剂与可待因/对乙酰氨基酚复方胶囊用于慢性疼痛管理的比较试验。
Clin Ther. 2001 Sep;23(9):1429-45. doi: 10.1016/s0149-2918(01)80118-1.
9
Tramadol versus codeine and the short-term risk of cardiovascular events in patients with non-cancer pain: A population-based cohort study.曲马多与可待因及非癌性疼痛患者心血管事件短期风险：一项基于人群的队列研究。
Br J Clin Pharmacol. 2022 Feb;88(4):1824-1834. doi: 10.1111/bcp.15099. Epub 2021 Nov 13.
10
Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis.曲马多与骨关节炎患者全因死亡率的相关性。
JAMA. 2019 Mar 12;321(10):969-982. doi: 10.1001/jama.2019.1347.

引用本文的文献

1
Adopting a Framework for Rapid Real-World Data Analyses in Safety Signal Assessment.采用框架快速进行真实世界数据安全性信号评估分析。
Ther Innov Regul Sci. 2024 Nov;58(6):1014-1022. doi: 10.1007/s43441-024-00694-7. Epub 2024 Sep 6.
2
Innovations in pharmacovigilance studies of medicines in older people.老年人药物警戒研究的创新
Br J Clin Pharmacol. 2025 Jan;91(1):66-83. doi: 10.1111/bcp.16049. Epub 2024 Mar 26.
3
The Pain Management of Trauma Patients in the Emergency Department.急诊科创伤患者的疼痛管理

本文引用的文献

1
Assessing the Need for Proton Pump Inhibitors for Patients Using Long-Term Nonsteroidal Anti-inflammatory Drugs without a History of Ulcers.评估无溃疡病史的长期使用非甾体抗炎药患者对质子泵抑制剂的需求。
Can J Hosp Pharm. 2020 May-Jun;73(3):216-217. Epub 2020 Jun 1.
2
Association of Tramadol Use With Risk of Hip Fracture.曲马多使用与髋部骨折风险的关联
J Bone Miner Res. 2020 Apr;35(4):631-640. doi: 10.1002/jbmr.3935. Epub 2020 Feb 5.
3
Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments.
J Clin Med. 2023 May 5;12(9):3289. doi: 10.3390/jcm12093289.
慢性疼痛与睡眠障碍：对其关系、共病及治疗的实用综述
Pain Med. 2020 Jun 1;21(6):1142-1152. doi: 10.1093/pm/pnz343.
4
Evaluating large-scale propensity score performance through real-world and synthetic data experiments.通过真实数据和合成数据实验评估大规模倾向评分性能。
Int J Epidemiol. 2018 Dec 1;47(6):2005-2014. doi: 10.1093/ije/dyy120.
5
Epidemiology and social costs of hip fracture.髋部骨折的流行病学与社会成本
Injury. 2018 Aug;49(8):1458-1460. doi: 10.1016/j.injury.2018.04.015. Epub 2018 Apr 20.
6
Empirical confidence interval calibration for population-level effect estimation studies in observational healthcare data.基于观察性医疗保健数据的人群效应估计研究的经验置信区间校准。
Proc Natl Acad Sci U S A. 2018 Mar 13;115(11):2571-2577. doi: 10.1073/pnas.1708282114.
7
Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: risks versus benefits.质子泵抑制剂与非甾体抗炎药联合处方：风险与益处
J Pain Res. 2018 Feb 14;11:361-374. doi: 10.2147/JPR.S156938. eCollection 2018.
8
Management of Acute Hip Fracture.急性髋部骨折的管理
N Engl J Med. 2017 Nov 23;377(21):2053-2062. doi: 10.1056/NEJMcp1611090.
9
Channeling in the Use of Nonprescription Paracetamol and Ibuprofen in an Electronic Medical Records Database: Evidence and Implications.在电子病历数据库中使用非处方对乙酰氨基酚和布洛芬的渠道：证据和影响。
Drug Saf. 2017 Dec;40(12):1279-1292. doi: 10.1007/s40264-017-0581-7.
10
Accuracy of an automated knowledge base for identifying drug adverse reactions.用于识别药物不良反应的自动化知识库的准确性。
J Biomed Inform. 2017 Feb;66:72-81. doi: 10.1016/j.jbi.2016.12.005. Epub 2016 Dec 16.