Archives of Osteoporosis最新文献

{"title":"Survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association","authors":"Joon Kiong Lee, Paul James Mitchell, Seng Bin Ang, Leilani Basa Mercado-Asis, Reynaldo Rey-Matias, Jianan Li, Leon Flicker, Edward Leung, David Choon, Sankara Kumar Chandrasekaran, Jacqueline Clare Therese Close, Hannah Seymour, Cyrus Cooper, Philippe Halbout, Robert Daniel Blank, Yanling Zhao, Rajesh Malhotra, Aasis Unnanuntana, Yew Lok Woo, Zairin Noor, Rong-Sen Yang, Irewin Tabu, Syed Shahidul Islam, Muhammad Amin Chinoy, Sonali Pande, Buland Thapa, Ronald Man Yeung Wong, Ketan Pande, Ding-Cheng (Derrick) Chan","doi":"10.1007/s11657-024-01375-6","DOIUrl":"https://doi.org/10.1007/s11657-024-01375-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">\u0000<i>Summary</i>\u0000</h3><p>A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific.</p><h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies. The current incidence of hip and other fragility fractures across the Asia Pacific region is enormous and set to escalate rapidly in the coming decades. This publication describes findings of a survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association (APOA) conducted in 2022.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The survey was developed as a collaboration between the Asia Pacific Osteoporosis and Fragility Fracture Society and the Asia Pacific Fragility Fracture Alliance, and included questions relating to aspects of care upon presentation, during surgery and mobilisation, secondary fracture prevention, and access to specific services.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In total, 521 APOA members completed the survey and marked variation in delivery of care was evident. Notable findings included:</p><ul>\u0000<li>\u0000<p>Fifty-nine percent of respondents indicated that analgesia was routinely initiated in transit (by paramedics) or within 30 minutes of arrival in the Emergency Department.</p>\u0000</li>\u0000<li>\u0000<p>One-quarter of respondents stated that more than 80% of their patients underwent surgery within 48 hours of admission.</p>\u0000</li>\u0000<li>\u0000<p>One-third of respondents considered non-hip, non-vertebral fractures to merit assessment of future fracture risk.</p>\u0000</li>\u0000<li>\u0000<p>One-third of respondents reported the presence of an Orthogeriatric Service in their hospital, and less than a quarter reported the presence of a Fracture Liaison Service.</p>\u0000</li>\u0000</ul><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>A Call to Action for all National Orthopaedic Associations affiliated with APOA is proposed to improve the care of fragility fracture patients across the region.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140589734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporotic quality of life, self-efficacy, and fracture protection behaviors in postmenopausal women.","authors":"Gamze Ünver, Aysun Özlü, Ahmet Erdoğan, Muhammed Fatih Özdemir, Sema Üstündağ","doi":"10.1007/s11657-024-01377-4","DOIUrl":"10.1007/s11657-024-01377-4","url":null,"abstract":"<p><p>It is important for postmenopausal women to acquire bone health protective behaviors to protect them from fractures. For this reason, it is necessary to evaluate bone health during menopause and to inform women.</p><p><strong>Purpose: </strong>This study was conducted to examine osteoporotic fracture protection behaviors, quality of life, and self-efficacy in postmenopausal women.</p><p><strong>Methods: </strong>In the study, the data were evaluated with the socio-demographic data form, Osteoporotic Fracture Protection Scale, Osteoporosis Self-Efficacy-Efficacy Scale, European Osteoporosis Foundation Quality of Life Questionnaire-41, which includes introductory information on socio-demographic characteristics.</p><p><strong>Results: </strong>It was determined that the postmenopausal women included in our study were between the ages of 45-92; more than half of them had chronic diseases; their average BMI was 29; and their DEXA score was - 3.00 ± 0.41. Among the people included in our study, those with a history of fractures had lower self-efficacy scores. It was determined that the fracture prevention scale scores of the participants were above the average, and the average of the osteoporosis-related quality of life score was high. In addition, it was determined that there was a strong positive correlation between self-efficacy and fracture prevention scale.</p><p><strong>Conclusion: </strong>It is important to determine behaviors to prevent osteoporotic fractures in postmenopausal women, to raise the necessary awareness and to inform patients about the precautions to be taken. It is thought that it will increase patients' quality of life by increasing their disease-related self-efficacy. Therefore, there is a need for research on providing education to op patients and examining the results.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dutch multidisciplinary guideline osteoporosis and fracture prevention, taking a local guideline to the international arena.","authors":"J P van den Bergh, P Geusens, N M Appelman-Dijkstra, H J G van den Broek, P J M Elders, G de Klerk, M van Oostwaard, H C Willems, M C Zillikens, W F Lems","doi":"10.1007/s11657-024-01378-3","DOIUrl":"10.1007/s11657-024-01378-3","url":null,"abstract":"<p><strong>Background: </strong>In 2018, a grant was provided for an evidence-based guideline on osteoporosis and fracture prevention based on 10 clinically relevant questions.</p><p><strong>Methods: </strong>A multidisciplinary working group was formed with delegates from Dutch scientific and professional societies, including representatives from the patient's organization and the Dutch Institute for Medical Knowledge. The purpose was to obtain a broad consensus among all participating societies to facilitate the implementation of the updated guideline.</p><p><strong>Results: </strong>Novel recommendations in our guideline are as follows: - In patients with an indication for DXA of the lumbar spine and hips, there is also an indication for VFA. - Directly starting with anabolic drugs (teriparatide or romosozumab) in patients with a very high fracture risk; - Directly starting with zoledronic acid in patients 75 years and over with a hip fracture (independent of DXA); - Directly starting with parenteral drugs (denosumab, teriparatide, zoledronic acid) in glucocorticoid-induced osteoporosis with very high fracture risk; - A lifelong fracture risk management, including lifestyle, is indicated from the start of the first treatment.</p><p><strong>Conclusion: </strong>In our new multidisciplinary guideline osteoporosis and fracture prevention, we developed 5 \"relatively new statements\" that are all a crucial step forward in the optimization of diagnosis and treatment for fracture prevention. We also developed 5 flowcharts, and we suppose that this may be helpful for individual doctors and their patients in daily practice and may facilitate implementation.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10987374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between alcohol intake and bone mineral density: results from the NHANES 2005-2020 and two-sample Mendelian randomization.","authors":"Bowen Lai, Heng Jiang, Rui Gao, Xuhui Zhou","doi":"10.1007/s11657-024-01382-7","DOIUrl":"10.1007/s11657-024-01382-7","url":null,"abstract":"<p><p>We used the data from the NHANES cross-sectional study among 14,113 participants and indicated a positive correlation between alcohol intake frequency and bone mineral density in different body sites. Mendelian randomization was conducted, and no causal relationship is significant between these two variables. The study can provide some suggestions on the daily consumption of alcohol for osteoporosis patients.</p><p><strong>Purpose: </strong>The effect of alcohol intake on bone mineral density (BMD) remains unclear. This study explored the association and causality between alcohol intake and BMD.</p><p><strong>Methods: </strong>Based on the 2005-2020 National Health and Nutrition Examination Survey including 14,113 participants, we conducted co-variate-adjusted multilinear regression analyses to explore the association between alcohol intake levels and spine or femur BMD. To evaluate the causal association between alcohol intake frequency and bone mineral density, the inverse variance weighted approach of two-sample Mendelian randomization (MR) was used with genetic data from the Medical Research Council Integrative Epidemiology Unit (462,346 cases) for alcohol intake frequency and the Genetic Factors for Osteoporosis Consortium (28,496 cases) for lumbar spine and femur neck BMD (32,735 cases).</p><p><strong>Results: </strong>Compared with non-drinkers, total femur BMDs but not total spine BMD increased with daily alcohol intake in males (β = 3.63*10^-2 for mild drinkers, β = 4.21*10^-2 for moderate drinkers, and β = 4.26*10^-2 for heavy drinkers). By contrast, the higher total spine BMD in females was related to higher alcohol intake levels (β = 2.15*10^-2 for mild drinkers, β = 2.59*10^-2 for moderate drinkers, and β = 3.88*10^-2 for heavy drinkers). Regarding the two-sample MR results, no causal relationship was observed between alcohol intake frequency and lumbar spine BMD (odds ratio [OR] = 1.016, P = 0.789) or femur neck BMD (OR = 1.048, P = 0.333).</p><p><strong>Conclusion: </strong>This study suggests a positive association between alcohol intake frequency and BMD, although the causal relationship was not significant.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone mineral density T-scores comparison between obese and non-obese individuals included in a Fracture Liaison Service following a recent fragility fracture.","authors":"Gauthier Marchasson, Cécile Philippoteaux, Isabelle Legroux-Gérot, Béhal Hélène, Bernard Cortet, Julien Paccou","doi":"10.1007/s11657-024-01379-2","DOIUrl":"10.1007/s11657-024-01379-2","url":null,"abstract":"<p><p>We used data from a Fracture Liaison Service to compare the mean T-scores of obese and non-obese patients after a recent fragility fracture. After adjusting for age, sex, and diabetes mellitus, T-score values were significantly higher at all measurement sites in obese patients, with a mean difference of 1 SD.</p><p><strong>Purpose: </strong>This study aimed to compare the mean T-scores of obese and non-obese patients after recent fragility fractures.</p><p><strong>Methods: </strong>Over a period of 5 and a half years, from January 2016 to May 2021, patients from a fracture liaison service were identified and their demographic characteristics, osteoporosis risk factors, BMD T-scores, and fracture sites were compared between obese (BMI ≥ 30 kg/m²) and non-obese (19 kg/m² < BMI < 30 kg/m²) patients.</p><p><strong>Results: </strong>A total of 712 patients were included (80.1% women; mean age 73.8 ± 11.3 years). Sixteen % had type 2 diabetes mellitus and 80% had a major osteoporotic fracture (MOF). 135 patients were obese and 577 non-obese, with obese patients younger (p < 0.001) and more frequently female (p = 0.03). Obese patients presented with fewer hip fractures (10% vs. 21%, p = 0.003) and more proximal humerus fractures (16% vs. 7%, p < 0.001) than non-obese patients. After adjusting for age, sex, and diabetes mellitus, BMD T-score values were significantly higher at all measurement sites (lumbar spine, total hip, and femoral neck) in obese patients than in non-obese patients for all types of fractures, with a mean difference of 1 standard deviation (p < 0.001 for all comparisons). The same results were observed in the population limited to MOF.</p><p><strong>Conclusions: </strong>Given the crucial role of BMD T-score in determining the need for anti-osteoporotic medication following fragility fractures, it is reasonable to question the existing T-score thresholds in obese patients.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of anti-osteoporosis medications in preventing vertebral body fractures after balloon kyphoplasty.","authors":"Masaki Ueno, Yusuke Tajima, Shogo Ito, Masaki Tsuji, Emi Toriumi, Aki Yoshii, Nanaka Otake, Hisashi Tanaka","doi":"10.1007/s11657-024-01374-7","DOIUrl":"10.1007/s11657-024-01374-7","url":null,"abstract":"<p><p>This retrospective study compared the efficacy of anabolic agents (romosozumab and teriparatide) with that of alendronate in preventing subsequent vertebral body fractures (SVBFs) after balloon kyphoplasty (BKP). All anabolic agents significantly reduced SVBFs. Romosozumab was most effective in increasing bone mineral density (BMD) and completely suppressed distant vertebral body fractures.</p><p><strong>Introduction: </strong>To determine optimal anti-osteoporosis medications, we compared romosozumab and teriparatide to alendronate as a control from perioperative BKP to the 1st postoperative year for treatment and secondary fracture prevention in osteoporosis.</p><p><strong>Methods: </strong>A total of 603 patients who underwent initial BKP for osteoporotic vertebral fractures were evaluated and categorized into five groups based on drug administration: romosozumab (group R, 155 patients), twice-weekly teriparatide (group TW, 48), weekly teriparatide (group W, 151), daily teriparatide (group D, 138), and alendronate (control) (group C, 111). The 1-year incidence of SVBFs, BMD change rate, and probability of requiring BKP were compared among the groups.</p><p><strong>Results: </strong>SVBF incidence was 3.9%, 6.5%, 8.3%, 6.0%, and 14.4% in groups R, D, TW, W, and C, respectively, with all other groups exhibiting significantly lower rates than group C. The groups that administered the anabolic agents had a notably lower incidence of distant fractures than group C. Compared with group C, group R showed significantly higher BMD change rates in lumbar vertebral bodies at 4, 8, and 12 months and group D at 12 months. Anabolic agent groups exhibited significantly higher improvement rates than group C after conservative treatment alone.</p><p><strong>Conclusion: </strong>The anabolic agents were found to be more effective at reducing the incidence of SVBF (especially distant vertebral fractures) than alendronate. These agents decreased the rate of repeat BKP even after the occurrence of a fracture. Overall, the use of an anabolic agent for the treatment of osteoporosis after BKP is better than the use of alendronate, even when treatment is initiated in the perioperative stage.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-dependent FRAX-based assessment and intervention thresholds for therapeutic decision making in osteoporosis in the Malaysian population.","authors":"Jeyakantha Ratnasingam, Mariyam Niyaz, Shanmugam Mariyappan, Terence Ong, Siew Pheng Chan, Fen Lee Hew, Swan Sim Yeap, Shanty Velaiutham, Subashini C Thambiah, Sarath Lekamwasam","doi":"10.1007/s11657-024-01371-w","DOIUrl":"https://doi.org/10.1007/s11657-024-01371-w","url":null,"abstract":"<p><p>Fracture risk stratification is crucial in countries with limited access to bone density measurement. 24.8% women were in the high-risk category while 30.4% were in the low-risk category. In the intermediate risk group, after recalculation of fracture risk with bone density, 38.3% required treatment. In more than half, treatment decisions can be made without bone density.</p><p><strong>Purpose: </strong>We aimed to examine the role of age-dependent intervention thresholds (ITs) applied to the Fracture Risk Assessment (FRAX) tool in therapeutic decision making for osteoporosis in the Malaysian population.</p><p><strong>Methods: </strong>Data were collated from 1380 treatment-naïve postmenopausal women aged 40-85 years who underwent bone mineral density (BMD) measurements for clinical reasons. Age-dependent ITs, for both major osteoporotic fracture (MOF) and hip fracture (HF), were calculated considering a woman with a BMI of 25 kg/m², aged between 40 and 85years, with a prior fragility fracture, sans other clinical risk factors. Those with fracture probabilities equal to or above upper assessment thresholds (UATs) were considered to have high fracture risk. Those below the lower assessment thresholds (LATs) were considered to have low fracture risk.</p><p><strong>Results: </strong>The ITs of MOF and HF ranged from 0.7 to 18% and 0.2 to 8%, between 40 and 85years. The LATs of MOF ranged from 0.3 to 11%, while those of HF ranged from 0.1 to 5.2%. The UATs of MOF and HF were 0.8 to 21.6% and 0.2 to 9.6%, respectively. In this study, 24.8% women were in the high-risk category while 30.4% were in the low-risk category. Of the 44.8% (n=618) in the intermediate risk group, after recalculation of fracture risk with BMD input, 38.3% (237/618) were above the ITs while the rest (n=381, 61.7%) were below the ITs. Judged by the Youden Index, 11.5% MOF probability which was associated with a sensitivity of 0.62 and specificity of 0.83 and 4.0% HF probability associated with a sensitivity of 0.63 and a specificity 0.82 were found to be the most appropriate fixed ITs in this analysis.</p><p><strong>Conclusion: </strong>Less than half of the study population (44.8%) required BMD for osteoporosis management when age-specific assessment thresholds were applied. Therefore, in more than half, therapeutic decisions can be made without BMD based on these assessment thresholds.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence insights into osteoporosis: assessing ChatGPT's information quality and readability.","authors":"Yakup Erden, Mustafa Hüseyin Temel, Fatih Bağcıer","doi":"10.1007/s11657-024-01376-5","DOIUrl":"10.1007/s11657-024-01376-5","url":null,"abstract":"<p><p>Accessible, accurate information, and readability play crucial role in empowering individuals managing osteoporosis. This study showed that the responses generated by ChatGPT regarding osteoporosis had serious problems with quality and were at a level of complexity that that necessitates an educational background of approximately 17 years.</p><p><strong>Purpose: </strong>The use of artificial intelligence (AI) applications as a source of information in the field of health is increasing. Readable and accurate information plays a critical role in empowering patients to make decisions about their disease. The aim was to examine the quality and readability of responses provided by ChatGPT, an AI chatbot, to commonly asked questions regarding osteoporosis, representing a major public health problem.</p><p><strong>Methods: </strong>\"Osteoporosis,\" \"female osteoporosis,\" and \"male osteoporosis\" were identified by using Google trends for the 25 most frequently searched keywords on Google. A selected set of 38 keywords was sequentially inputted into the chat interface of the ChatGPT. The responses were evaluated with tools of the Ensuring Quality Information for Patients (EQIP), the Flesch-Kincaid Grade Level (FKGL), and the Flesch-Kincaid Reading Ease (FKRE).</p><p><strong>Results: </strong>The EQIP score of the texts ranged from a minimum of 36.36 to a maximum of 61.76 with a mean value of 48.71 as having \"serious problems with quality.\" The FKRE scores spanned from 13.71 to 56.06 with a mean value of 28.71 and the FKGL varied between 8.48 and 17.63, with a mean value of 13.25. There were no statistically significant correlations between the EQIP score and the FKGL or FKRE scores.</p><p><strong>Conclusions: </strong>Although ChatGPT is easily accessible for patients to obtain information about osteoporosis, its current quality and readability fall short of meeting comprehensive healthcare standards.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140157447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of mortality one year after pelvic fractures in an older population: a retrospective cohort study.","authors":"Sofie Desmet, Sigrid Janssens, Michiel Herteleer, Nathalie Noppe, Michaël R Laurent, Evelien Gielen, Marian Dejaeger","doi":"10.1007/s11657-024-01373-8","DOIUrl":"10.1007/s11657-024-01373-8","url":null,"abstract":"<p><p>The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after pelvic fracture. Multivariate logistic regression identified male gender, comorbidities and presence of in-hospital complications as predictors of 1-year mortality.</p><p><strong>Purpose: </strong>Osteoporotic pelvic fractures have significant mortality and morbidity in the older population. The aim of this study was to investigate the factors predicting one-year mortality of patients sustaining a low-impact pelvic fracture (pelvic ring and acetabulum).</p><p><strong>Methods: </strong>A total of 282 patients aged ≥ 65 years presenting with a low-energy pelvic ring (n =254) or acetabular (n =28) fracture to the emergency department at the University Hospitals Leuven were included. Demographic and clinical data were retrospectively collected and predictors for mortality one year after pelvic ring fractures were evaluated.</p><p><strong>Results: </strong>The one-year mortality after osteoporotic pelvic ring fractures and acetabular fractures was respectively 20.4% (95% CI 15.7-26.0) and 14% (95% CI 4.0-32.7). Multivariate logistic regression adjusted for confounders identified male gender (OR 3.18; 95% CI (1.06-9.49), p =0.038), a higher number of comorbidities (OR 1.5; 95% CI (1.16-1.95), p =0.002) and in-hospital complications (OR 5.00; 95% CI (1.39-17.97), p =0.014) as independent predictors of one-year mortality after pelvic ring fractures.</p><p><strong>Conclusion: </strong>The one-year mortality after low-energy pelvic is high and can be predicted by different patient characteristics. These findings can guide pelvis fracture treatment decisions in the older population.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of a deep learning model for predicting bone mineral density on chest radiographs.","authors":"Takamune Asamoto, Yasuhiko Takegami, Yoichi Sato, Shunsuke Takahara, Norio Yamamoto, Naoya Inagaki, Satoshi Maki, Mitsuru Saito, Shiro Imagama","doi":"10.1007/s11657-024-01372-9","DOIUrl":"10.1007/s11657-024-01372-9","url":null,"abstract":"<p><p>We developed a new model for predicting bone mineral density on chest radiographs and externally validated it using images captured at facilities other than the development environment. The model performed well and showed potential for clinical use.</p><p><strong>Purpose: </strong>In this study, we performed external validation (EV) of a developed deep learning model for predicting bone mineral density (BMD) of femoral neck on chest radiographs to verify the usefulness of this model in clinical practice.</p><p><strong>Methods: </strong>This study included patients who visited any of the collaborating facilities from 2010 to 2020 and underwent chest radiography and dual-energy X-ray absorptiometry (DXA) at the femoral neck in the year before and after their visit. A total of 50,114 chest radiographs were obtained, and BMD was measured using DXA. We developed the model with 47,150 images from 17 facilities and performed EV with 2914 images from three other facilities (EV dataset). We trained the deep learning model via ensemble learning based on chest radiographs, age, and sex to predict BMD using regression. The outcomes were the correlation of the predicted BMD and measured BMD with diagnoses of osteoporosis and osteopenia using the T-score estimated from the predicted BMD.</p><p><strong>Results: </strong>The mean BMD was 0.64±0.14 g/cm² in the EV dataset. The BMD predicted by the model averaged 0.61±0.08 g/cm², with a correlation coefficient of 0.68 (p<0.01) when compared with the BMD measured using DXA. The accuracy, sensitivity, and specificity of the model were 79.0%, 96.6%, and 34.1% for T-score < -1 and 79.7%, 77.1%, and 80.4% for T-score ≤ -2.5, respectively.</p><p><strong>Conclusion: </strong>Our model, which was externally validated using data obtained at facilities other than the development environment, predicted BMD of femoral neck on chest radiographs. The model performed well and showed potential for clinical use.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}