PDF(Pubmed)
Abstract：
UNASSIGNED: There are limited data on the management of bone health, including bone mineral density (BMD) evaluation and osteoporosis (OP) treatment, in patients undergoing elective orthopaedic surgeries.
UNASSIGNED: This was a retrospective cohort study using administrative claims data from Symphony Health, PatientSource for patients aged ≥50 years with documented kyphoplasty/vertebroplasty (KP/VP), total knee arthroplasty (TKA), and total hip arthroplasty (THA). Risk stratification to identify patients at very high risk for fracture (VHRFx) was based on clinical practice guideline recommendations to the extent information on variables of interest were available from the claims database.
UNASSIGNED: A total of 251 919 patients met inclusion criteria: KP/VP (31 018), TKA (149 849), and THA (71 052). The majority were female (80.3%) with a mean (SD) age of 68.5 (7.5) years. Patients undergoing KP/VP were older and had a greater comorbidity burden associated with risk for falls, mobility issues, muscle weakness, and respiratory and cardiovascular diseases. In the 6 months before surgery, 11.8% of patients were tested and/or received treatment for OP. Patients undergoing KP/VP were more likely to be tested and/or treated (17.5%) than patients undergoing TKA (11.0%) or THA (10.9%). Overall, men had a lower rate of testing and/or treatment than women (4.6% vs 13.5%). In the 12 months before surgery, patients with an OP diagnosis and at VHRFx (30.8%) had a higher rate of treatment and/or testing than those without OP (11.5%), or those without OP but with a fracture in the year preceding surgery (10.2%).
UNASSIGNED: Bone health management is suboptimal in patients undergoing elective orthopaedic surgeries and is worse in men than in women. Proper management of OP before and after surgery may improve outcomes.
UNASSIGNED: This was a retrospective cohort study using administrative claims data from Symphony Health, PatientSource for patients aged ≥50 years with documented kyphoplasty/vertebroplasty (KP/VP), total knee arthroplasty (TKA), and total hip arthroplasty (THA). Risk stratification to identify patients at very high risk for fracture (VHRFx) was based on clinical practice guideline recommendations to the extent information on variables of interest were available from the claims database.
UNASSIGNED: A total of 251 919 patients met inclusion criteria: KP/VP (31 018), TKA (149 849), and THA (71 052). The majority were female (80.3%) with a mean (SD) age of 68.5 (7.5) years. Patients undergoing KP/VP were older and had a greater comorbidity burden associated with risk for falls, mobility issues, muscle weakness, and respiratory and cardiovascular diseases. In the 6 months before surgery, 11.8% of patients were tested and/or received treatment for OP. Patients undergoing KP/VP were more likely to be tested and/or treated (17.5%) than patients undergoing TKA (11.0%) or THA (10.9%). Overall, men had a lower rate of testing and/or treatment than women (4.6% vs 13.5%). In the 12 months before surgery, patients with an OP diagnosis and at VHRFx (30.8%) had a higher rate of treatment and/or testing than those without OP (11.5%), or those without OP but with a fracture in the year preceding surgery (10.2%).
UNASSIGNED: Bone health management is suboptimal in patients undergoing elective orthopaedic surgeries and is worse in men than in women. Proper management of OP before and after surgery may improve outcomes.
摘要：
■关于骨骼健康管理的数据有限，包括骨密度（BMD）评估和骨质疏松症（OP）治疗，接受择期骨科手术的患者。
■这是一项回顾性队列研究，使用SymphonyHealth的行政索赔数据，患者年龄≥50岁，有椎体后凸成形术/椎体成形术（KP/VP），全膝关节置换术（TKA），全髋关节置换术（THA）。根据临床实践指南建议，根据索赔数据库中有关感兴趣变量的信息进行风险分层，以识别骨折风险（VHRFx）的患者。
■总共251.919例患者符合纳入标准：KP/VP（31.018），TKA(149.849),和THA（71.052）。大多数是女性（80.3％），平均（SD）年龄为68.5（7.5）岁。接受KP/VP治疗的患者年龄较大，与跌倒风险相关的合并症负担更大。流动性问题，肌肉无力,以及呼吸系统和心血管疾病。手术前6个月,11.8%的患者接受了OP测试和/或治疗。接受KP/VP的患者比接受TKA（11.0%）或THA（10.9%）的患者更有可能接受测试和/或治疗（17.5%）。总的来说,男性的检测和/或治疗率低于女性(4.6%vs13.5%).在手术前的12个月里，诊断为OP且处于VHRFx的患者（30.8%）的治疗和/或检测率高于无OP的患者（11.5%），或在手术前一年没有OP但骨折的人（10.2％）。
骨健康管理在接受择期骨科手术的患者中是次优的，男性比女性更差。手术前后对OP的适当管理可能会改善预后。
■这是一项回顾性队列研究，使用SymphonyHealth的行政索赔数据，患者年龄≥50岁，有椎体后凸成形术/椎体成形术（KP/VP），全膝关节置换术（TKA），全髋关节置换术（THA）。根据临床实践指南建议，根据索赔数据库中有关感兴趣变量的信息进行风险分层，以识别骨折风险（VHRFx）的患者。
■总共251.919例患者符合纳入标准：KP/VP（31.018），TKA(149.849),和THA（71.052）。大多数是女性（80.3％），平均（SD）年龄为68.5（7.5）岁。接受KP/VP治疗的患者年龄较大，与跌倒风险相关的合并症负担更大。流动性问题，肌肉无力,以及呼吸系统和心血管疾病。手术前6个月,11.8%的患者接受了OP测试和/或治疗。接受KP/VP的患者比接受TKA（11.0%）或THA（10.9%）的患者更有可能接受测试和/或治疗（17.5%）。总的来说,男性的检测和/或治疗率低于女性(4.6%vs13.5%).在手术前的12个月里，诊断为OP且处于VHRFx的患者（30.8%）的治疗和/或检测率高于无OP的患者（11.5%），或在手术前一年没有OP但骨折的人（10.2％）。
骨健康管理在接受择期骨科手术的患者中是次优的，男性比女性更差。手术前后对OP的适当管理可能会改善预后。
