Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score
Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns o...
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doaj-84f35b2d6dc246a1815273463381cb372020-11-24T21:46:26ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012017-11-011411138010.3390/ijerph14111380ijerph14111380Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians ScoreCheng-Shyuan Rau0Shao-Chun Wu1Pao-Jen Kuo2Yi-Chun Chen3Peng-Chen Chien4Hsiao-Yun Hsieh5Ching-Hua Hsieh6Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanDepartment of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, TaiwanBackground: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region.https://www.mdpi.com/1660-4601/14/11/1380femaleosteoporosisOsteoporosis Self-Assessment Tool for Asians (OSTA)traumapropensity-score matchingfemoral fracturebone mineral density (BMD) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cheng-Shyuan Rau Shao-Chun Wu Pao-Jen Kuo Yi-Chun Chen Peng-Chen Chien Hsiao-Yun Hsieh Ching-Hua Hsieh |
spellingShingle |
Cheng-Shyuan Rau Shao-Chun Wu Pao-Jen Kuo Yi-Chun Chen Peng-Chen Chien Hsiao-Yun Hsieh Ching-Hua Hsieh Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score International Journal of Environmental Research and Public Health female osteoporosis Osteoporosis Self-Assessment Tool for Asians (OSTA) trauma propensity-score matching femoral fracture bone mineral density (BMD) |
author_facet |
Cheng-Shyuan Rau Shao-Chun Wu Pao-Jen Kuo Yi-Chun Chen Peng-Chen Chien Hsiao-Yun Hsieh Ching-Hua Hsieh |
author_sort |
Cheng-Shyuan Rau |
title |
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score |
title_short |
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score |
title_full |
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score |
title_fullStr |
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score |
title_full_unstemmed |
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score |
title_sort |
epidemiology of bone fracture in female trauma patients based on risks of osteoporosis assessed using the osteoporosis self-assessment tool for asians score |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2017-11-01 |
description |
Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region. |
topic |
female osteoporosis Osteoporosis Self-Assessment Tool for Asians (OSTA) trauma propensity-score matching femoral fracture bone mineral density (BMD) |
url |
https://www.mdpi.com/1660-4601/14/11/1380 |
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