Desarrollo y validaci n de un cuestionario predictivo de osteoporosis (OPARG score)

Abstract

Introducción

Se encuentran descritos múltiples factores de riesgo (FR) asociados a la osteoporosis. Evaluamos la capacidad predictiva, individual y colectiva de los mismos. El trabajo consta de dos fases sucesivas; inicialmente se desarrolló un modelo predictivo y luego se validó prospectivamente.

Materiales y métodos

Se construyó un cuestionario de FR y se interrogó a las mujeres que participaron antes de realizar absorciometría dual de rayos X (DEXA). Se diseñó un modelo predictivo y se aplicó en una nueva población.

Resultados

Fase inicial: 785 mujeres (osteoporosis: 26,11%). La edad, postmenopausia, datos antropométricos y antecedentes de fracturas demostraron ser los FR más relevantes. El modelo es aplicable a mujeres postmenopáusicas. Fase de validación: 502 pacientes postmenopáusicas (osteoporosis: 27,49%). Se puso de manifiesto una correlación significativa entre lo observado en la población estudiada y lo predicho por el modelo.

Conclusión

Una puntuación mayor o igual a 3 es indicación de realizar un procedimiento diagnóstico. Este método puede utilizarse para optimizar la selección de pacientes de mayor riesgo.

Introduction

Several risk factors (RF) have been associated to the development of osteoporosis. We have evaluated the predictive capacity of many of them in two phases. Initially we developed a predictive score and then we validated the model prospectively.

Material and methods

A questionnaire on RF was designed. The women were questioned prior to performing a bone mineral density measurement by DXA. A predictive score was designed. This was applied to a new population.

Results

During the first phase 785 women were included. 26.11% of them were diagnosed as having osteoporosis according to the WHO definition. Age, postmenopausal state, personal history of fracture and weight were shown to be the most relevant RF. The score is applicable to postmenopausal women.

Validation phase 502 postmenopausal women (osteoporosis: 27.49%) were included. A significant correlation was observed between that observed in the population studied and that predicted by the score.

Conclusion

A score ≥ 3 warranted performing a diagnostic procedure. This method may be used to optimize identifying patients at high risk.