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Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score

Author

Listed:
  • Cheng-Shyuan Rau

    (Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
    These authors contribute equally to this paper.)

  • Shao-Chun Wu

    (Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
    These authors contribute equally to this paper.)

  • Pao-Jen Kuo

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan)

  • Yi-Chun Chen

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan)

  • Peng-Chen Chien

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan)

  • Hsiao-Yun Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan)

  • Ching-Hua Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan)

Abstract

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.

Suggested Citation

  • Cheng-Shyuan Rau & Shao-Chun Wu & Pao-Jen Kuo & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2017. "Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score," IJERPH, MDPI, vol. 14(11), pages 1-15, November.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:11:p:1380-:d:118670
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    References listed on IDEAS

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    1. Cheng-Shyuan Rau & Pao-Jen Kuo & Shao-Chun Wu & Yi-Chun Chen & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2016. "Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis," IJERPH, MDPI, vol. 13(12), pages 1-14, December.
    2. Chien-Chang Chen & Cheng-Shyuan Rau & Shao-Chun Wu & Pao-Jen Kuo & Yi-Chun Chen & Hsiao-Yun Hsieh & Ching-Hua Hsieh, 2016. "Association of Osteoporosis Self-Assessment Tool for Asians (OSTA) Score with Clinical Presentation and Expenditure in Hospitalized Trauma Patients with Femoral Fractures," IJERPH, MDPI, vol. 13(10), pages 1-15, October.
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    Cited by:

    1. Chien-En Tang & Hang-Tsung Liu & Pao-Jen Kuo & Yi-Chun Chen & Shiun-Yuan Hsu & Chih-Che Lin & Ching-Hua Hsieh, 2018. "Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis," IJERPH, MDPI, vol. 15(3), pages 1-12, February.
    2. Wei-Ti Su & Shao-Chun Wu & Chun-Ying Huang & Sheng-En Chou & Ching-Hua Tsai & Chi Li & Shiun-Yuan Hsu & Ching-Hua Hsieh, 2020. "Geriatric Nutritional Risk Index as a Screening Tool to Identify Patients with Malnutrition at a High Risk of In-Hospital Mortality among Elderly Patients with Femoral Fractures—A Retrospective Study ," IJERPH, MDPI, vol. 17(23), pages 1-9, November.

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