库希综合征骨矿物密度测量的明显缺失:基于美国保险索赔数据库的全国性研究
Amirhossein Ghaseminejad-Raeini1, Amir Human Hoveidaei2, Fatemeh Zarepour3
1School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
概括
骨矿物密度 (BMD) 测试在库辛综合征患者中未得到充分使用,只有6.40%的患者进行了查. 这突出了显著的护理差距,特别是男性和老年人,需要改进骨质疏松症查工作.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 医疗保健的不平等 医疗保健的不平等
背景情况:
- 库希综合征 (CS) 是由于长时间的高葡萄糖皮质激素水平造成的,导致骨矿物质密度 (BMD) 丧失和骨质疏松症风险增加.
- 尽管制定了指导方针,骨质疏松症在CS患者中仍未得到确诊.
- 美国CS患者的BMD测试的实际患病率以前是未知的,这表明潜在的护理缺口.
研究的目的:
- 调查骨矿物质密度 (BMD) 测试在被诊断患有库辛综合征的大量美国患者队列中的利用情况.
- 为了确定与该患者群体中骨质疏松症测试率相关的人口和临床因素.
- 为了确定骨质疏松症诊断在接受BMD测试的库辛综合征患者中的患病率.
主要方法:
- 对PearlDiver患者记录数据库 (2010-2020年) 进行了回顾性分析.
- 被纳入的患者被诊断患有库辛综合征,并接受了BMD测试,不包括那些先前被诊断患有骨质疏松症的患者.
- 统计分析包括t测试,奇平方测试和后勤回归 (p < 0.001).
主要成果:
- 在53,101名库辛综合征患者中,只有6.40%的患者在诊断后两年内接受了BMD测试.
- 女性,年轻患者和那些有商业保险或居住在中西部的人更有可能接受测试.
- 男性性别,年龄较大,并较高的并发症得分与测试减少有关,而肥胖和慢性病增加了测试的可能性. 骨质疏松症在12.56%的测试患者中被诊断出.
结论:
- 在库辛综合征患者中,遵守BMD查指南的水平仍然非常低.
- 根据性别,年龄和并发症,测试率存在显著差异.
- 完善的查方案是改善骨质疏松症的检测和管理在这个有风险的人群必不可少的.
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