Abstract
BackgroundTo compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM).MethodsA cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined.ResultsThere were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value.ConclusionsBoth BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.
Highlights
Osteoporotic vertebral compression fracture (OVCF) is the most common complication of primary osteoporosis, which often occurs in postmenopausal women, and troubles many elderly men. 1/5 of men around the world are threatened by osteoporotic fractures after the age of 50 [1]
Because we focused on the ability of FRAX tools to identify and predict painful osteoporotic vertebral compression fractures in this study, we selected a model for the likelihood of osteoporotic fractures within 10 years without bone mineral density measurements [23]
Our results show that the sensitivity of bone mineral density (BMD) in assessing the risk of fracture is moderate, with a sensitivity of 71.93% in the femoral neck, 64.91% in the total hip and 79.53% in the lumbar spine, respectively, and the specificity in the lumbar spine is only 44.3%, so the specificity is less acceptable in the lumbar spine
Summary
Osteoporotic vertebral compression fracture (OVCF) is the most common complication of primary osteoporosis, which often occurs in postmenopausal women, and troubles many elderly men. 1/5 of men around the world are threatened by osteoporotic fractures after the age of 50 [1]. Osteoporotic vertebral compression fracture (OVCF) is the most common complication of primary osteoporosis, which often occurs in postmenopausal women, and troubles many elderly men. 1/5 of men around the world are threatened by osteoporotic fractures after the age of 50 [1]. The hospital mortality rate of OVCF patients ranged from 0.3% to 1.7%. This invisibly increases the social and economic burden. To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis selfassessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM)
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