Exploring the Predictive Capability of Osteoporosis Self-Assessment Tool for Asians Score for Fragility Fractures: A Retrospective Cohort Analysis Osteoporosis Self-Assessment Tool for Asians for Predicting Fragility Fractures
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Abstract
OBJECTIVE: The primary objective of the present study was to evaluate the predictive efficacy of the Osteoporosis Self-Assessment Tool for Asians (OSTA) in identifying individuals predisposed to fragility fractures.
METHODS: This retrospective cohort study involved 17,189 adults aged 50 years and older. We examined the relationship between osteoporosis risk and fragility fractures to establish fundamental insights into fragility fracture risk factors. Data were collected from the outpatient orthopedic department. The incidence rates (IRs) per person-year at risk were calculated based on the initial diagnosis of fragility fractures. Poisson regression analysis was used to ascertain the IR ratios (IRR), with adjustments made for factors including age, sex, income, occupation, comorbidities, and estrogen supplementation.
RESULTS: Among the 17,189 patients identified as healthy adults at baseline, 6,996 fragility fractures were recorded. The adjusted IRR for documented fragility fractures demonstrated a significant elevation among individuals categorized as medium or high risk for osteoporosis displayed a 1.24-[95% confidence interval (CI) 1.15-1.33] and 1.66-fold (95% CI = 1.51-1.83), respectively.
CONCLUSION: Our results highlight the increased risk of fragility fractures associated with medium and high-risk osteoporosis, as evaluated by OSTA and provide insights into potential strategies for mitigating the anticipated public health impact of osteoporotic fractures.
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References
Edwards MH, Dennison EM, Aihie Sayer A, Fielding R, Cooper C. Osteoporosis and sarcopenia in older age. Bone 2015;80:126-30.
Charoenngam N, Pongchaiyakul C. Current issues in evaluation and management of osteoporosis in Thailand. Osteoporos Sarcopenia 2023;9(2):53-9.
Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 1996;312(7041):1254-9.
Yoo JH, Moon SH, Ha YC, Lee DY, Gong HS, Park SY, et al. Osteoporotic fracture: 2015 position statement of the Korean society for bone and mineral research. J Bone Metab 2015;22(4):175-81.
Sanders KM, Pasco JA, Ugoni AM, Nicholson GC, Seeman E, Martin TJ, et al. The exclusion of high trauma fractures may underestimate the prevalence of bone fragility fractures in the community: the Geelong osteoporosis study. J Bone Miner Res 1998;13(8):1337-42.
Wright NC, Saag KG, Curtis JR, Smith WK, Kilgore ML, Morrisey MA, et al. Recent trends in hip fracture rates by race/ethnicity among older US adults. J Bone Miner Res 2012;27(11):2325-32.
Hopkins RB, Pullenayegum E, Goeree R, Adachi JD, Papaioannou A, Leslie WD, et al. Estimation of the lifetime risk of hip fracture for women and men in Canada. Osteoporos Int 2012;23(3):921-7.
Nakaoka D, Sugimoto T, Kaji H, Kanzawa M, Yano S, Yamauchi M, et al. Determinants of bone mineral density and spinal fracture risk in postmenopausal Japanese women. Osteoporos Int 2001;12(7):548-54.
Kanis JA, Harvey NC, Cooper C, Johansson H, Odén A, McCloskey EV. A systematic review of intervention thresholds based on FRAX:a report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 2016;11(1):25.
Prior JC, Langsetmo L, Lentle BC, Berger C, Goltzman D, Kovacs CS, et al. Ten-year incident osteoporosis-related fractures in the population-based Canadian multicentre osteoporosis study-comparing site and age-specific risks in women and men. Bone 2015;71:237-43.
Leslie WD, Metge C, Ward L. Contribution of clinical risk factors to bone density-based absolute fracture risk assessment in postmenopausal women. Osteoporos Int 2003;14(4):334-8.
Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. Bone density at various sites for prediction of hip fractures. The study of osteoporotic fractures research group. Lancet 1993;341(8837):72-5.
Muslim D, Mohd E, Sallehudin A, Tengku Muzaffar T, Ezane A. Performance of osteoporosis self-assessment tool for Asian (OSTA) for primary osteoporosis in post-menopausal Malay women. Malays Orthop J 2012;6(1):35-9.
Rau CS, Wu SC, Kuo PJ, Chen YC, Chien PC, Hsieh HY, et al. Epidemiology of bone fracture in female trauma patients based on risks of osteoporosis assessed using the osteoporosis self-assessment tool for Asians score. Int J Environ Res Public Health 2017;14(11):1380.
Valentin G, Ravn MB, Jensen EK, Friis K, Bhimjiyani A, Ben-Shlomo Y, et al. Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies. Osteoporos Int 2021;32(12):2433-48.
Valentin G, Pedersen SE, Christensen R, Friis K, Nielsen CP, Bhimjiyani A, et al. Socio-economic inequalities in fragility fracture outcomes: a systematic review and meta-analysis of prognostic observational studies. Osteoporos Int 2020;31(1):31-42.
Meng S, Tong M, Yu Y, Cao Y, Tang B, Shi X, et al. The prevalence of osteoporotic fractures in the elderly in China: a systematic review and meta-analysis. J Orthop Surg Res 2023;18(1):536.
Muslim D, Mohd E, Sallehudin A, Tengku Muzaffar T, Ezane A. Performance of osteoporosis self-assessment tool for Asian (OSTA) for primary osteoporosis in postmenopausal Malay women. Malays Orthop J 2012;6(1):35-9.
Chang KP, Center JR, Nguyen TV, Eisman JA. Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo osteoporosis epidemiology study. J Bone Miner Res 2004;19(4):532-6.
Yang S, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Association between hypertension and fragility fracture: a longitudinal study. Osteoporos Int 2014;25(1):97-103.
Pal C, Mani S, Pal AK, Ramuni K, Hassan HC. Assessment of risk factors and occurrence of osteoporotic fractures among low impact trauma clients in West Bengal, India. Enfermería Clínica 2020;30:6–11.
Jilka RL, Hangoc G, Girasole G, Passeri G, Williams DC, Abrams JS, et al. Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science 1992;257(5066):88-91.
Orimo H, Nakamura T, Hosoi T, Iki M, Uenishi K, Endo N, et al. Japanese 2011 guidelines for prevention and treatment of osteoporosis--executive summary. Arch Osteoporos 2012;7(1):3-20.
Hughes DE, Wright KR, Uy HL, Sasaki A, Yoneda T, Roodman GD, et al. Bisphosphonates promote apoptosis in murine osteoclasts in vitro and in vivo. J Bone Miner Res 1995;10(10):1478-87.