The association between type 2 diabetes mellitus, hip fracture, and post-hip fracture mortality: a multi-state cohort analysis

BMC Musculoskelet Disord

et al. 2020

Background: Osteoporosis is a highly prevalent disease identified by Dual Energy X-ray Absorptiometry (DEXA) that can be performed in an ambulatory (out-patient) or hospitalized population. We evaluated the use of baseline inhospital DEXA screening to identify osteoporosis in ambulatory care and hospitalized patients; we also assessed specific risk factors for osteoporosis among these populations. Methods: We included a baseline initial DEXA from 6406 consecutive patients at our tertiary referral University Hospital. Results: Osteoporosis was diagnosed in 22.3% of the study population. In univariate analysis, osteoporosis risk factors were age, fracture history and low BMI (for all 3 sites), but also corticotherapy (lumbar spine and femoral neck) and male (lumbar spine). In multivariate analysis, age, fracture history, low BMI, and male increased osteoporosis risk. In-hospital screening yielded a higher percentage of osteoporosis positive scans than ambulatory care screening (31.8% vs 18.5%, p < 0.001). In-hospital screening targeted an older and more predominantly male population with a higher fracture history. Z-scores revealed that this difference was not only due to an older age of the population and mainly concerned cortical bone. Conclusions: In-hospital osteoporosis screening revealed more osteoporosis than screening in ambulatory practice and could be an additional tool to improve the identification and management of osteoporosis. In addition to typical risk factors, we identified male gender as associated with osteoporosis detection in our cohort.

Section: Discussionmentioning

confidence: 99%

High detection rate of osteoporosis with screening of a general hospitalized population: a 6-year study in 6406 patients in a university hospital setting

BMC Musculoskelet Disord

et al. 2020

Section: Discussionmentioning

confidence: 99%

High detection rate of osteoporosis with screening of a general hospitalized population: a 6-year study in 6406 patients in a University Hospital setting.

et al. 2020

Preprint

Background: Osteoporosis is a highly prevalent disease identified by Dual Energy X-ray Absorptiometry (DEXA) that can be performed in an ambulatory (out-patient) or hospitalized population. We evaluated the use of baseline in-hospital DEXA screening to identify osteoporosis in ambulatory care and hospitalized patients; we also assessed specific risk factors for osteoporosis among these populations. Methods: We included a baseline initial DEXA from 6406 consecutive patients at our tertiary referral University Hospital. Results: Osteoporosis was diagnosed in 22.3% of the study population. In univariate analysis, osteoporosis risk factors were age, fracture history and low BMI (for all 3 sites), but also corticotherapy (lumbar spine and femoral neck) and male (lumbar spine). In multivariate analysis, age, fracture history, low BMI, and male increased osteoporosis risk. In-hospital screening yielded a higher percentage of osteoporosis positive scans than ambulatory care screening (31.8% vs 18.5%, p<0.001).In-hospital screening targeted an older and more predominantly male population with a higher fracture history. Z-scores revealed that this difference was not only due to an older age of the population and mainly concerned cortical bone. Conclusions: In-hospital osteoporosis screening revealed more osteoporosis than screening in ambulatory practiceand could be an additional tool to improve the identification and management of osteoporosis. In addition to typical risk factors, we identified male as an osteoporosis risk factor in our cohort.

“…As 78% of the cohort came from medicine departments, comorbidities or treatment that we could suppose more numerous in this population could also negatively influenced bone mineral density (inflammatory systemic disease with e.g. rheumatoid arthritis [19], polymyalgia rheumatica [20], systemic erythematous lupus [21]; inflammatory bowel disease [22]; mellitus diabetes [23]; renal failure [24]; lung disease [25]…). Due to this better efficiency, emphasis should be put on the in-hospital osteoporosis screening, because it's the place where much co-morbiditiy accumulate.…”

Section: Discussionmentioning

confidence: 99%

High detection rate of osteoporosis with screening of a general hospitalized population: a 6-year study in 6406 patients in a University Hospital setting.

et al. 2019

Preprint

Introduction: Osteoporosis is a highly prevalent disease identified by Dual Energy X-ray Absorptiometry (DEXA) that can be performed in an ambulatory (out-patient) or hospitalized population. We evaluated the use of baseline in-hospital DEXA screening to identify osteoporosis in ambulatory care and hospitalized patients; we also assessed specific risk factors for osteoporosis among these populations. Methods: We included a baseline initial DEXA from 6406 consecutive patients at our tertiary referral University Hospital. Results: Osteoporosis was diagnosed in 22.3% of the study population. In univariate analysis, osteoporosis risk factors were age, fracture history and low BMI (for all 3 sites), but also corticotherapy (lumbar spine and femoral neck) and male gender (lumbar spine). In multivariate analysis, age, fracture history, low BMI, and male gender increased osteoporosis risk. In-hospital screening yielded a higher percentage of osteoporosis positive scans than ambulatory care screening (31.8% vs 18.5%, p<0.001). In-hospital screening targeted an older and more predominantly male population with a higher fracture history. Z-scores revealed that this difference was not only due to an older age of the population and mainly concerned cortical bone. This suggests the existence of more numerous comorbidities deleterious for bone health in hospitalized patients. Conclusions: In-hospital osteoporosis screening was more effective than screening in ambulatory practice and could be an additional tool to improve the identification and management of osteoporosis. In addition to typical risk factors, we identified male gender as an osteoporosis risk factor in our cohort.