一个新的关节骨折临床预测模型:瑞典总人口的开发和验证研究
Peter Nordström1, Viktor H Ahlqvist1,2,3, Marcel Ballin1,4
1Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden.
EClinicalMedicine
|October 21, 2024
概括
一个新的临床模型准确地预测了没有骨密度扫描的关节骨折风险. 这个工具可以识别需要骨质疏松症治疗的个体,而家庭主妇服务的使用是脆弱性的关键指标.
科学领域:
- 老年学是指老年学的学科.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 低骨密度和骨质疏松症需要骨特异性治疗.
- 准确的部骨折风险预测至关重要,特别是鉴于临床实践中骨密度数据有限.
- 大多数关节骨折患者没有骨质疏松症,这凸显了对替代预测方法的需求.
研究的目的:
- 在老年人群中开发和验证关节骨折风险的临床预测模型.
- 在没有骨密度数据的情况下评估模型的性能.
- 确定关节骨折的关键预测因素,并确定启动骨特异性治疗的门.
主要方法:
- 在2005年使用整个瑞典50岁以上人口的开发和验证研究 (N=3,340,977).
- 全国注册数据的交叉链接,包括诊断,药物,家庭,与脆弱相关的和社会经济因素.
- 用于开发和验证5年关节骨折风险预测算法的多变量模型,在非瑞典背景个体的子队列中进行验证.
主要成果:
- 超过1520万人年,87,089次关节骨折发生在5年内.
- 最终的模型包括了19个变量,解释了>90%的关节骨折风险 (人口归因部分).
- 除了年龄之外,最强的预测因素是家庭主妇服务的使用,帕金森病和痴呆症;3%的5年风险值建议开始治疗.
结论:
- 一个经过验证的临床预测模型可以在没有骨密度数据的情况下准确估计关节骨折风险.
- 该模型的高人口可归因分数强调了其广泛临床应用的潜力.
- 估计5年关节骨折风险为3%被提议作为考虑骨特异性治疗的门.
更多相关视频
08:20A Reliable and Reproducible Critical-Sized Segmental Femoral Defect Model in Rats Stabilized with a Custom External Fixator
Published on: March 24, 2019
8.6K
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
7.0K
相关概念视频
01:40Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:31Bone Remodeling and Repair
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...
01:09Changes in the Appendicular Skeleton with Age
The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...