{"title":"评估髋关节手术患者骨质疏松症自我评估工具对亚洲人的实用性","authors":"Keisuke Uemura , Kazuma Takashima , Ryo Higuchi , Sotaro Kono , Hirokazu Mae , Makoto Iwasa , Hirohito Abe , Yuki Maeda , Takayuki Kyo , Takashi Imagama , Wataru Ando , Takashi Sakai , Seiji Okada , Hidetoshi Hamada","doi":"10.1016/j.afos.2024.01.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.</p></div><div><h3>Methods</h3><p>A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.</p></div><div><h3>Results</h3><p>DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of −5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.</p></div><div><h3>Conclusions</h3><p>OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.</p></div>","PeriodicalId":19701,"journal":{"name":"Osteoporosis and Sarcopenia","volume":"10 1","pages":"Pages 16-21"},"PeriodicalIF":2.5000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405525524000190/pdfft?md5=2d1e05c2c50b4602d973ef7e9c461e14&pid=1-s2.0-S2405525524000190-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery\",\"authors\":\"Keisuke Uemura , Kazuma Takashima , Ryo Higuchi , Sotaro Kono , Hirokazu Mae , Makoto Iwasa , Hirohito Abe , Yuki Maeda , Takayuki Kyo , Takashi Imagama , Wataru Ando , Takashi Sakai , Seiji Okada , Hidetoshi Hamada\",\"doi\":\"10.1016/j.afos.2024.01.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.</p></div><div><h3>Methods</h3><p>A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.</p></div><div><h3>Results</h3><p>DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of −5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.</p></div><div><h3>Conclusions</h3><p>OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. 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引用次数: 0
摘要
目的骨质疏松症的诊断和治疗有助于获得良好的髋关节手术效果。使用双能 X 射线吸收测量法(DXA)测量骨质密度(BMD)是诊断骨质疏松症的黄金标准。然而,由于使用 DXA 的机会有限,因此需要一种筛查工具来识别骨质疏松症风险较高的患者。我们分析了亚洲人骨质疏松症自我评估工具(OSTA)作为骨质疏松症筛查工具的潜在效用。通过 DXA 测量了每位患者股骨近端区域的 BMD(DXA-BMD),并评估了其与 OSTA 评分(连续变量)的相关性。为评估 OSTA 评分预测骨质疏松症的能力,还进行了接收者操作特征(ROC)曲线分析。最后,对 OSTA 评分进行截断,得出一个整数(OSTA 指数),以明确每个指数在骨质疏松症患者中所占的百分比。根据 ROC 曲线分析,最佳 OSTA 评分临界值为 -5.4,诊断骨质疏松症的灵敏度为 73.8%,特异度为 80.9%(曲线下面积:0.842)。OSTA 指数每降低一个单位,骨质疏松症的概率就会增加 7.3%。我们的研究结果可能有助于确定需要使用 DXA 进一步检查的高风险患者。
Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery
Objectives
Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.
Methods
A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.
Results
DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of −5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.
Conclusions
OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.
Osteoporosis and SarcopeniaOrthopedics, Sports Medicine and Rehabilitation, Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Geriatrics and Gerontology