PDF(Pubmed)
Abstract：
UNASSIGNED: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established.
UNASSIGNED: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations.
UNASSIGNED: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use.
UNASSIGNED: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks.
UNASSIGNED: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations.
UNASSIGNED: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use.
UNASSIGNED: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks.
摘要：
未经证实：骨折是创伤事件后常见的损伤。非甾体类抗炎药（NSAIDs）治疗与骨折相关的急性疼痛的疗效和安全性尚不明确。
UNASSIGNED：确定了在明确定义患者人群的创伤诱发骨折中使用NSAID的临床相关问题。干预措施，比较和适当选择的结果(PICO)。这些问题围绕功效(疼痛控制，减少阿片类药物的使用)和安全性(不愈合，肾损伤）。进行了系统评价，包括文献检索和荟萃分析，根据建议分级评估对证据质量进行分级，开发和评估(等级)方法。工作组就基于证据的最后建议达成共识。
未经评估：共确定了19项研究进行分析。并非所有研究都报告了所有被确定为至关重要的结果，疼痛控制结果的异质性太大,无法进行荟萃分析.九项研究报道了不愈合（三项随机对照试验），其中6例报告与NSAIDs无相关性。与未接受NSAIDs的患者相比，接受NSAIDs的患者不愈合的总发生率为2.99%和2.19%(p=0.04)。分别。在报告疼痛控制和减少阿片类药物的研究中，非甾体抗炎药的使用减少了创伤性骨折后疼痛和阿片类药物的需要.一项研究报道了急性肾损伤的结果，发现与使用NSAID无关。
未经授权：在创伤性骨折患者中，非甾体抗炎药似乎可以减轻创伤后的疼痛，减少对阿片类药物的需求，对不愈合的影响很小。我们有条件地建议在患有创伤性骨折的患者中使用NSAIDs，因为其益处似乎超过了小的潜在风险。
UNASSIGNED：确定了在明确定义患者人群的创伤诱发骨折中使用NSAID的临床相关问题。
未经评估：共确定了19项研究进行分析。
未经授权：在创伤性骨折患者中，
