制定髋臼骨折的核心结局指标集：一项系统评价（第一部分）

Developing a core outcome set for acetabular fractures: a systematic review (part I).

作者信息

Schulz Denise, Gaeth Catharina, Jordan Martin C, Herath Steven C, Spering Christopher, Bieler Dan, Windolf Joachim, Neubert Anne

机构信息

Department of Orthopaedics and Traumatology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.

TraumaEvidence @ German Society of Trauma Surgery, Berlin, Germany.

出版信息

Syst Rev. 2025 Apr 9;14(1):83. doi: 10.1186/s13643-025-02824-0.

DOI:10.1186/s13643-025-02824-0

PMID:40205445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11983908/

Abstract

BACKGROUND

There are indications that clinical studies investigating the surgical treatment of acetabular fractures assess different outcomes. This heterogeneity reduces the comparability of study results and, thus, limits the knowledge generated from research. Core outcome sets (COS) contain a minimum set of outcomes that should be measured in studies investigating a specific disease or injury. A COS for surgically treated acetabular fractures does not yet exist. Therefore, the aim of this study is to identify the reported outcomes in studies investigating the surgical treatment of acetabular fractures.

METHODS

Studies including skeletally mature individuals (≥ 16 years) with isolated acetabular fractures treated surgically were included. Studies with polytrauma patients, pathological fractures, additional pelvic fractures, exclusively non-surgical treatment, or juvenile individuals were excluded. Three databases and two clinical trial registries were searched on 15 November 2022. The identified outcomes were grouped and subsequently categorized according to the Core Outcome Measures in Effectiveness Trials Guidelines.

RESULTS

A total of 193 studies were included, which reported a cumulative total of 2581 outcomes. After grouping, 266 unique outcomes were identified. No outcome was examined in all studies. Pain, ability to walk independently, range of motion, quality of reduction, and heterotopic ossification were the most reported unique outcomes and assessed in at least 60% of included studies. A total of 105 outcomes were only assessed in one of the included studies. Outcomes of all five core areas and 25 outcome domains of the Core Outcome Measures in Effectiveness Trials taxonomy were examined. Furthermore, outcomes were named and defined differently, measured at different time points, and assessed using a variety of measurement instruments.

CONCLUSION

Overall, this systematic review shows that a wide range of outcomes are measured in studies examining surgical treatment of acetabular fractures. The results of this systematic review will be used in a subsequent study to develop the COS for surgically treated acetabular fractures by using the Delphi method.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO: CRD42022357644; COMET: 2123.

摘要

背景

有迹象表明，调查髋臼骨折手术治疗的临床研究评估的结果不同。这种异质性降低了研究结果的可比性，从而限制了从研究中获得的知识。核心结局集（COS）包含在研究特定疾病或损伤时应测量的最少一组结局。目前尚无针对手术治疗髋臼骨折的核心结局集。因此，本研究的目的是确定调查髋臼骨折手术治疗的研究中报告的结局。

方法

纳入包括骨骼成熟个体（≥16岁）且接受手术治疗的孤立髋臼骨折的研究。排除多发伤患者、病理性骨折、额外骨盆骨折、仅接受非手术治疗或青少年个体的研究。于2022年11月15日检索了三个数据库和两个临床试验注册库。将确定的结局进行分组，随后根据有效性试验指南中的核心结局指标进行分类。

结果

共纳入193项研究，这些研究报告的结局累计总数为2581项。分组后，确定了266项独特的结局。并非所有研究都检查了任何一项结局。疼痛、独立行走能力、活动范围、复位质量和异位骨化是报告最多的独特结局，至少60%的纳入研究对其进行了评估。共有105项结局仅在其中一项纳入研究中进行了评估。检查了有效性试验分类法所有五个核心领域和25个结局领域的结局。此外，结局的命名和定义不同，在不同时间点进行测量，并使用多种测量工具进行评估。