结核病和骨质疏松性骨折风险:使用全国性队列研究开发个性化骨折风险估计预测模型
Hayoung Choi1, Jungeun Shin2, Jin-Hyung Jung3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Frontiers in public health
|May 9, 2024
概括
与普通人群相比,结核病幸存者面临的骨折风险增加. 一个新的模型有助于预测这些患者的个体骨折风险,帮助预防工作.
科学领域:
- 整形外科 整形外科 整形外科
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 幸存者经历持续的炎症和治疗后骨折风险升高.
- 关于对结核病幸存者的个性化骨折风险预测存在重大知识差距.
研究的目的:
- 为了估计结核病幸存者的骨折风险.
- 确定结核病幸存者的骨折相关的因素.
- 为结核病幸存者开发个性化骨折风险预测模型.
主要方法:
- 建立了一个由44453名结核病幸存者组成的队列,与对照组匹配1:1.
- 随访时间平均为3.4年,分析骨折发生率,死亡或研究结束.
- 考克斯的比例危险回归被用来比较风险和确定导致因素.
主要成果:
- 结核病幸存者表现出明显更高的骨折率 (19.3/1000人年) 比对照 (14.6/1000人年).
- 调整后的分析证实所有骨折的风险都更高 (aHR 1.27),包括部和脊椎骨折.
- 确定的主要危险因素是肺结核,女性性别,年龄,酒精使用,运动量低,以及高的查尔森并发症指数.
结论:
- 与匹配的对照组相比,结核病幸存者患骨折的风险较高.
- 一个个性化的预测模型证明了骨折风险评估的良好歧视.
- 这种模型可以帮助制定有针对性的骨折预防策略,特别是在高风险的结核病幸存者群体中.
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