Opportunistic screening for metabolic bone disease in high energy fracture patients

被引：0

作者：

Gordon, Garrett ^{[1
]}

Johnson, Brian ^{[2
]}

Marquardt, Olivia ^{[1
]}

Young, Dylan ^{[1
]}

Beltran, Michael J. ^{[1
]}

Pierrie, Sarah N. ^{[3
,4
]}

机构：

[1] Univ Cincinnati, Coll Med, Cincinnati, OH 45267 USA

[2] Med Coll Georgia, Dept Orthopaed Surg, Augusta, GA USA

[3] Atrium Hlth Musculoskeletal Inst, Dept Orthopaed Surg, Charlotte, NC USA

[4] Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2025年 / 56卷 / 03期

关键词：

Metabolic bone disease; Opportunistic screening; High energy trauma; Bone densitometry; Osteoporosis; COMPUTED-TOMOGRAPHY; FOLLOW-UP; OSTEOPOROSIS; LUMBAR; CT; OUTCOMES; SCANS;

D O I：

10.1016/j.injury.2025.112147

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: Metabolic bone disease (MBD, referring to osteopenia and osteoporosis) and its sequelae are associated with substantial morbidity, mortality, and healthcare costs. MBD screening and bone densitometry referral are underutilized in the general population despite published screening guidelines. Prior studies have correlated vertebral body Hounsfield unit (HU) measurements with MBD. The purpose of this study is to use this method to identify the prevalence of undiagnosed MBD in patients presenting to the hospital after high energy trauma, and to determine whether opportunistic MBD screening using this method would be valuable in this cohort. Design: Retrospective review. Setting: Level 1 trauma center and safety net hospital. Patients: 307 patients with a high energy femur fracture who underwent abdomen/pelvis computed tomography (CT) were identified from a trauma database. Intervention: L1 vertebral body radio density (in Hounsfield units, HU) was measured from trauma CT scans. Risk factors for MBD were identified from the medical record. Main outcome measurements: Prevalence of MBD and proportion of patients with MBD risk factors meriting further work-up. Results: The prevalence of MBD among high energy trauma patients was similar to the age-matched general population. Over half (50.5 %) of all patients had at least one risk factor for MBD. Among patients 50 to 64 years of age with any given MBD risk factor, over a third of individuals had MBD. In this population, the prevalence of MBD was highest (40.0 %) among those who used tobacco products and had a concurrent alcohol use disorder. Conclusion: Opportunistic screening for MBD using a CT measurement technique can facilitate earlier diagnosis and treatment for affected individuals presenting after high energy trauma. Opportunistic screening may be particularly impactful in pre-menopausal women and in men, who frequently have MBD risk factors but who have a low referral rate for bone density testing and treatment. Level of evidence: Diagnostic level III.

引用

页数：5

共 21 条

[11] Schreiber J.J., Anderson P.A., Hsu W.K., Use of computed tomography for assessing bone mineral density, Neurosurg Focus, 37, 1, (2014)
[12] Kim K.J., Kim D.H., Lee J.I., Choi B.K., Han I.H., Nam K.H., Hounsfield units on lumbar computed tomography for predicting regional bone mineral density, Open Med (Wars), 14, pp. 545-551, (2019)
[13] Pirayesh Islamian J., Garoosi I., Abdollahi Fard K., Abdollahi M.R., Comparison between the MDCT and the DXA scanners in the evaluation of BMD in the lumbar spine densitometry, Egypt J Radiol Nucl Med, 47, 3, pp. 961-967, (2016)
[14] Wright N.C., Looker A.C., Saag K.G., Curtis J.R., Delzell E.S., Randall S., Et al., The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine, J Bone Miner Res, 29, 11, pp. 2520-2526, (2014)
[15] Sarafrazi N., Wambogo E.A., Shepherd J.A., Osteoporosis or low bone mass in older adults: united states, 2017–2018, (2021)
[16] LeBoff M.S., Greenspan S.L., Insogna K.L., Lewiecki E.M., Saag K.G., Singer A.J., Et al., The clinician's guide to prevention and treatment of osteoporosis, Osteoporos Int, 33, 10, pp. 2049-2102, (2022)
[17] Watts N.B., Adler R.A., Bilezikian J.P., Drake M.T., Eastell R., Orwoll E.S., Et al., Osteoporosis in men: an endocrine society clinical practice guideline, J Clin Endocrinol Metab, 97, 6, pp. 1802-1822, (2012)
[18] Shuhart C.R., Yeap S.S., Anderson P.A., Jankowski L.G., Lewiecki E.M., Morse L.R., Et al., Executive summary of the 2019 ISCD position development conference on monitoring treatment, DXA cross-calibration and least significant change, spinal cord injury, peri-prosthetic and orthopedic bone health, transgender medicine, and pediatrics, J Clin Densitom, 22, 4, pp. 453-471, (2019)
[19] Gausden E.B., Nwachukwu B.U., Schreiber J.J., Lorich D.G., Lane J.M., Opportunistic use of CT imaging for osteoporosis screening and bone density assessment: a qualitative systematic review, J Bone Joint Surg Am, 99, 18, pp. 1580-1590, (2017)
[20] Truong E.I., DeMario B.S., Hendrickson S., Kalina M.J., Vallier H.A., Tseng E.S., Et al., Factors influencing nonadherence to recommended post discharge follow-up after trauma, J Surg Res, 256, pp. 143-148, (2020)

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