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首页> 外文期刊>International Journal of Environmental Research and Public Health >Association of Osteoporosis Self-Assessment Tool for Asians (OSTA) Score with Clinical Presentation and Expenditure in Hospitalized Trauma Patients with Femoral Fractures
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Association of Osteoporosis Self-Assessment Tool for Asians (OSTA) Score with Clinical Presentation and Expenditure in Hospitalized Trauma Patients with Femoral Fractures

机译：亚洲人骨质疏松症自我评估工具（OSTA）得分与住院创伤性股骨骨折患者的临床表现和支出的关系

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Background : A cross-sectional study to investigate the association of Osteoporosis Self-Assessment Tool for Asians (OSTA) score with clinical presentation and expenditure of hospitalized adult trauma patients with femoral fractures. Methods : According to the data retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2015, a total of 2086 patients aged ≥40 years and hospitalized for treatment of traumatic femoral bone fracture were categorized as high-risk patients (OSTA < ?4, n = 814), medium-risk patients (?1 ≥ OSTA ≥ ?4, n = 634), and low-risk patients (OSTA > ?1, n = 638). 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 using Number Crunching Statistical Software (NCSS) software (NCSS 10; NCSS Statistical Software, Kaysville, UT, USA), with adjusted covariates including mechanism and Glasgow Coma Scale (GCS); injuries were assessed based on the Abbreviated Injury Scale (AIS), and Injury Severity Score (ISS) was used to evaluate the effect of OSTA-related grouping on a patient’s outcome. Results : High-risk and medium-risk patients were predominantly female, presented with significantly older age and higher incidences of co-morbidity, and were injured in a fall accident more frequently than low-risk patients. High-risk patients and medium-risk patients had a different pattern of femoral fracture and a significantly lower ISS. Although high-risk and medium-risk patients had significantly shorter lengths hospital of stay (LOS) and less total expenditure than low-risk patients did, similar results were not found in the selected propensity score-matched patients, implying that the difference may be attributed to the associated injury severity of the patients with femoral fracture. However, the charge of surgery is significantly lower in high-risk and medium-risk patients than in low-risk patients, regardless of the total population or the selected propensity score-matched patients. This lower charge of surgery may be attributed to a less aggressive surgery applied for older patients with high or medium risk of osteoporosis. Conclusions : This study of hospitalized trauma patients with femoral fracture according to OSTA risk classification revealed that high-risk and medium-risk patients had significantly higher odds of sustaining injury in a fall accident than low-risk patients; they also present a different pattern of femoral bone fracture as well as a significantly lower ISS, shorter hospital LOS, and less total expenditure. In addition, the significantly lower charge of surgery in high-risk and medium-risk patients than in low-risk patients may be because of the preference of orthopedists for less aggressive surgery in dealing with older patients with osteoporotic femoral bone fracture.
机译：背景：一项横断面研究旨在研究亚洲人骨质疏松症自我评估工具（OSTA）得分与住院治疗的股骨骨折成人创伤患者的临床表现和支出之间的关系。方法：根据2009年1月1日至2015年12月31日从创伤登记系统获得的数据，将共2086名年龄≥40岁并住院治疗创伤性股骨骨折的患者归为高危患者（OSTA <？ 4，n = 814），中危患者（≥1 OSTA≥≥4，n = 634）和低危患者（OSTA>≥1，n = 638）。使用双面Pearson检验，卡方检验或Fisher精确检验来比较分类数据。未配对学生的t检验和Mann-Whitney U检验分别用于分析正态分布和非正态分布的连续数据。使用数字紧缩统计软件（NCSS）软件（NCSS 10; NCSS Statistics Software，Kaysville，UT，USA）以1：1的比例进行倾向得分匹配，并调整了协变量，包括机制和格拉斯哥昏迷量表（GCS）;根据简短伤害量表（AIS）评估伤害，并使用伤害严重度评分（ISS）评估OSTA相关分组对患者结局的影响。结果：高危和中危患者主要为女性，年龄明显偏高，合并症发病率更高，并且在跌倒事故中受伤的发生率比低危患者高。高危患者和中危患者的股骨骨折类型不同，ISS明显降低。尽管高危和中危患者的住院时间（LOS）明显短于低危患者，而总支出却少于低危患者，但在与倾向评分匹配的所选患者中未发现相似的结果，这表明差异可能是归因于股骨骨折患者的相关损伤严重程度。但是，无论总人群或倾向评分匹配的患者如何，高危和中危患者的手术费用均明显低于低危患者。这种较低的手术费用可能归因于对患有骨质疏松症高风险或中等风险的老年患者进行的较不积极的手术。结论：根据OSTA危险性分类对住院的股骨骨折创伤患者进行的研究表明，高风险和中风险患者摔倒事故中遭受持续伤害的几率明显高于低风险患者。他们还表现出了不同的股骨骨折类型，ISS显着降低，住院LOS缩短，总支出减少。此外，高风险和中风险患者的手术费用明显低于低风险患者，这可能是由于骨科医生更倾向于选择较不积极的手术来治疗骨质疏松性股骨骨折的老年患者。

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