Evidence map›Paper›PMID 27141945›Full record

Observational studyBMC musculoskeletal disorders2016

Non-steroidal anti-inflammatory drugs and the risk of a second hip fracture: a propensity-score matching study.

Po-Yao Chuang, Shih-Hsun Shen, Tien-Yu Yang, Tsan-Wen Huang, Kuo-Chin Huang

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC musculoskeletal disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05025228 (Analgesic Effect of Paracetamol in Patients With Femur Fracture), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05025228 completednot on this mapstarted 2019, after this paper: background citation

Analgesic Effect of Paracetamol in Patients With Femur Fracture: is Intravenous Better Than Oral?

TypeobservationalSponsorFondazione Policlinico Universitario Agostino Gemelli IRCCSRan2019 to 2020Enrolled170ConditionsFemur FractureArmsParacetamol
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Review
  7. Factors associated with fracture after stroke and TIA: a long-term follow-up.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Po-Yao ChuangDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Shih-Hsun ShenDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Tien-Yu YangDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Tsan-Wen HuangDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Kuo-Chin HuangDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. kc2672@gmail.com.
Chiayi Chang Gung Memorial Hospital · TWChang Gung University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for elderly patients, particularly after a hip fracture. However, we are not clear about the effect of NSAIDs on the risk of a second hip fracture because of confounding factors.

methodsThis was a Taiwan National Health Insurance Research Database-based study using propensity-score matching (PSM) to control for confounding. Enrollees were selected from patients with a hip fracture during 1996-2004 and followed longitudinally until December 2009. After PSM for comorbidities and bisphosphonate therapy, 94 patients with a second hip fracture were assigned to the Cases group and 461 without it to the Controls group. The target drugs are NSAIDs; paracetamol and dexamethasone are used for comparison.

resultsThe correlation between the mean daily-dose (MDD) ratios of NSAIDs and the probability values of the current statistical tests were highly negative (Pearson's r = -0.920, P = 0.003), which indicated that the higher the MDD ratios, the greater the risks of a second hip fracture. A Kaplan-Meier survival analysis showed a time-dependent trend of increasing risk of a second hip fracture in patients taking NSAIDs (P < 0.001). Moreover, patients ≥ 60 years old had a higher risk of a second hip fracture than did those <60 and taking the NSAIDs diclofenac (P = 0.016) and celecoxib (P = 0.003) and the corticosteroid dexamethasone (P = 0.018), but not those taking analgesic paracetamol (P = 0.074).

conclusionsWe conclude that taking NSAIDs after a fragility hip fracture dose- and time-dependently significantly increases the risk of a second hip fracture, especially in elderly patients. To lower the risk of a second hip fracture, any underlying causes for excessively using NSAIDs should be treated and thus fewer NSAIDs prescribed after a first hip fracture.

Indexed as

Propensity ScoreAcetaminophenAgedAnti-Inflammatory Agents, Non-SteroidalCase-Control StudiesDatabases, FactualDiclofenacDose-Response Relationship, DrugFemaleFollow-Up StudiesHip FracturesHumansMalePopulation SurveillanceRecurrenceRisk FactorsAcetaminophenAnti-Inflammatory Agents, Non-SteroidalDiclofenacFragility hip fractureNon-steroidal anti-inflammatory drugsPopulation-based studyPropensity-score matchingSecond hip fracture

Identifiers

PMID27141945
PMCPMC4855841
OpenAlexW2346512567

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.