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Pettit CJ, Herbosa CF, Ganta A, Rivero S, Tejwani N, Leucht P, Konda SR, Egol KA. Can We Predict 30-Day Readmission After Hip Fracture? J Orthop Trauma 2025; 39:200-206. [PMID: 39655937 DOI: 10.1097/bot.0000000000002946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2024] [Indexed: 03/15/2025]
Abstract
OBJECTIVES To determine the most common reason for 30-day readmission after hospitalization for hip fractures. METHODS DESIGN A retrospective review. SETTING Single academic medical center that includes a Level 1 trauma center. PATIENT SELECTION CRITERIA Included were all patients operatively treated for hip fractures (OTA 31) between October 2014 and November 2023. Patients who died during their initial admission were excluded. OUTCOME MEASURES AND COMPARISONS Patient demographics, hospital quality measures, outcomes, and readmission within 30 days after discharge for each patient were reviewed. Thirty-day readmission reason was recorded and correlation analysis was performed. RESULTS A total of 3032 patients were identified with a mean age of 82.1 years and 70.5% of patients being women. The 30-day readmission cohort was 2.6 years older ( P < 0.001) and 8.8% more male patients ( P = 0.027), had 0.5 higher Charleston comorbidity index ( P < 0.001), 0.3 higher American Society of Anesthesiologists class ( P < 0.001), and were 9.2% less independent at the time of admission ( P = 0.003). Hemiarthroplasty procedure (32.7% vs. 24.1%) was associated with higher 30-day readmission compared with closed percutaneous screw fixation (4.5% vs. 8.8%) and cephalomedullary nail fixation (52.2% vs. 54.4%, P < 0.001). Those readmitted by 30 days developed more major (16.7% vs. 8.0%; P < 0.001) and minor (50.5% vs. 36.4%; P < 0.001) complications during their initial hospitalization and had a 1.5-day longer length of stay during their first admission ( P < 0.001). Those discharged home were less likely to be readmitted within 30 days (20.7% vs. 27.6%, P = 0.008). Multivariate regression revealed increasing American Society of Anesthesiologists class (odds ratio 1.47, P = 0.002) and preinjury ambulatory status (odds ratio 1.42, P = 0.007) was most associated with increased 30-day readmission. The most common reason for readmission was pulmonary complications (17.1% of complications) including acute respiratory failure, chronic obstructive pulmonary disease exacerbation, and pneumonia. CONCLUSIONS Thirty-day readmission after hip fracture was associated with older, sicker patients with decreased preinjury ambulation status. Hemiarthroplasty for femoral neck fracture was also associated with readmission. The most common reason for 30-day readmission after hip fracture was pulmonary complications. LEVEL OF EVIDENCE Prognostic Level III. See instructions for authors for a complete description of levels of evidence.
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Affiliation(s)
- Christopher J Pettit
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
| | - Carolyn F Herbosa
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
| | - Abhishek Ganta
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY
| | - Steven Rivero
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
| | - Nirmal Tejwani
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
| | - Philipp Leucht
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
| | - Sanjit R Konda
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
- Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY
| | - Kenneth A Egol
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and
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Gupta N, Patel H, Kasmenn M, Ricken RT, Anderson M, Turnow M, Manes T, Reznichenko E, Williamson TK, Karia R. Temporal and regional trends of fractures in the United States: A review of the global burden of disease database. J Orthop 2025; 62:207-215. [PMID: 40248514 PMCID: PMC12002757 DOI: 10.1016/j.jor.2025.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2025] [Accepted: 03/14/2025] [Indexed: 04/19/2025] Open
Abstract
Background Musculoskeletal diseases, including bone fractures, are a significant contributor to global disability. Understanding temporal and regional trends in bone fractures is crucial for effective healthcare planning and resource allocation. We sought to analyze recent epidemiological trends of different types of fractures in the United States and determine correlations and associations between fracture trends and potential influencing demographic factors (i.e. age, sex, regional-specific). Methods Data from the Global Burden of Disease Database were analyzed to examine fracture incidence, prevalence, and years lived with disability (YLDs). Statistical analyses were conducted to determine temporal trends and sex-based differences. Results The analysis revealed significant increases in hip fractures and decreases in pelvic fractures over time. Fractures of the patella, tibia, fibula, and ankle remain prevalent across all regions and sexes, with notable variations. Conclusions These findings underscore the importance of targeted interventions and resource allocation to address the burden of fractures on public health. Despite limitations, this study provides critical insights into fracture epidemiology, guiding future prevention and management strategies.
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Affiliation(s)
- Nithin Gupta
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Hursch Patel
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Maxwell Kasmenn
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Rileigh T. Ricken
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Michael Anderson
- Department of Orthopaedic Surgery, OhioHealth, Columbus, OH, USA
| | - Morgan Turnow
- Department of Orthopaedic Surgery, OhioHealth, Columbus, OH, USA
| | - Taylor Manes
- Department of Orthopaedic Surgery, OhioHealth, Columbus, OH, USA
| | - Elizaveta Reznichenko
- Department of Orthopaedic Surgery, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Tyler K. Williamson
- Department of Orthopaedic Surgery, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Ravi Karia
- Department of Orthopaedic Surgery, University of Texas Health San Antonio, San Antonio, TX, USA
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Ortíz Martínez JG, Bodu Lamberti EM, Karduss Preciado C, Polo Miranda MF. Experience of a centre of excellence in hip fractures of the elderly in Colombia: influence of time-to-surgery on inpatient mortality and complications. INTERNATIONAL ORTHOPAEDICS 2024; 48:2499-2504. [PMID: 39107627 DOI: 10.1007/s00264-024-06249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/01/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE To analyse the time-to-surgery of a centre of excellence in hip fractures of the elderly and its influence on inpatient mortality and postoperative complications. METHODS A cross-sectional cohort study was conducted. The sample universe consisted of 4,364 patients admitted to a university clinic in Chía, Colombia during the year 2018 to 2023 with ICD-10 diagnoses corresponding to femur fractures. After eliminating duplicates and application of inclusion and exclusion criteria, the final sample included was 269 patients. Qualitative and quantitative variables were analysed, such as: sex, age, age group, type of fracture, type of surgical procedure, time-to-surgery, time to discharge, inpatient mortality and postoperative complications. RESULTS The mean time-to-surgery from admission was 70.16 h or 2.92 days (IQR 37-87). Patients were divided into three subgroups of time in which they were taken to surgery: <24 h (11.89%), 24-48 h (33.82%) and > 48 h (54.27%). The overall mortality rate was 1.85% for a total of five deceased patients, two of whom belonged to the 24-48-hour group and three to the > 48 h group. Higher rates of postoperative complications were observed in the > 48-hours group (n: 39, 14.49%), followed by the 24-48-hour group (n: 25, 9.29%) and the < 24-hour group (n: 7, 2.6%). CONCLUSIONS Patients operated for a hip fracture in > 48 h since admission had a slightly higher rate of postoperative complications. No significant difference was observed regarding inpatient mortality when compared to the 24-48-hour group.
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Paracuollo M, Tarulli FR, Pellegrino G, Pellegrino A. Proximal femoral nailing for intertrochanteric fracture combined with contralateral femoral neck local osteo-enhancement procedure (LOEP) for severe osteoporotic bone loss: An original Italian case series. Injury 2024; 55 Suppl 4:111408. [PMID: 39542574 DOI: 10.1016/j.injury.2024.111408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/14/2024] [Accepted: 01/27/2024] [Indexed: 11/17/2024]
Abstract
Proximal femoral fractures in elderly women are a major cause of morbidity and mortality worldwide and a public health concern. Although pharmacological therapies have shown potential in improving bone mineral density (BMD) and decreasing fracture risk, the current research effort is focused on developing a procedure that can ensure both immediate and long-term efficacy. A minimally-invasive surgical approach, known as AGN1 local osteo-enhancement procedure (LOEP), has been recently developed to promote bone augmentation. The procedure implies the preparation of an enhancement site, a specific location where new bone is required within a local bony area weakened by osteoporotic bone loss, and the insertion of a triphasic, resorbable, calcium-based implant material. The results of this procedure have shown a significant and sustainable long-term increase in the proximal femur BMD and consequently in bone strength, thereby improving the femoral neck's resistance to compression and distraction forces that may result in fall-related fractures. A preliminary case series of ten women, suffering from intertrochanteric fracture and contralateral proximal femur severe osteoporotic bone loss, who underwent a combined procedure of proximal femoral nailing and AGN1 local osteo-enhancement procedure, has been developed over the course of a year of clinical and radiological data collection.
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Affiliation(s)
- Mario Paracuollo
- III Division of Orthopaedics and Traumatology, "C.T.O." Hospital in Naples (NA), Viale Colli Aminei, 21 80131, Italy.
| | - Filippo Rosati Tarulli
- Department of Orthopaedics and Traumatology, "San Giuseppe Moscati" Hospital in Aversa (CE), Via Antonio Gramsci, 1-81031, Italy
| | - Giuseppe Pellegrino
- Department of Orthopaedics and Traumatology, "San Giuseppe Moscati" Hospital in Aversa (CE), Via Antonio Gramsci, 1-81031, Italy
| | - Achille Pellegrino
- Department of Orthopaedics and Traumatology, "San Giuseppe Moscati" Hospital in Aversa (CE), Via Antonio Gramsci, 1-81031, Italy
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Konnopka C, Büchele G, Jaensch A, Rothenbacher D, Becker C, Rapp K, Henken E, König HH. Evaluation of costs, osteoporosis treatment, and re-fractures in German collaborative orthogeriatric care after fragility fractures. Osteoporos Int 2024; 35:81-91. [PMID: 37940697 PMCID: PMC10786733 DOI: 10.1007/s00198-023-06965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/31/2023] [Indexed: 11/10/2023]
Abstract
Orthogeriatric co-management (OGCM) may provide benefits for geriatric fragility fracture patients in terms of more frequent osteoporosis treatment and fewer re-fractures. Yet, we did not find higher costs in OGCM hospitals for re-fractures or antiosteoporotic medication for most fracture sites within 12 months, although antiosteoporotic medication was more often prescribed. PURPOSE Evidence suggests benefits of orthogeriatric co-management (OGCM) for hip fracture patients. Yet, evidence for other fractures is rare. The aim of our study was to conduct an evaluation of economic and health outcomes after the German OGCM for geriatric fragility fracture patients. METHODS This retrospective cohort study was based on German health and long-term care insurance data. Individuals were 80 years and older, sustained a fragility fracture in 2014-2018, and were treated in hospitals certified for OGCM (ATZ group), providing OGCM without certification (OGCM group) or usual care (control group). Healthcare costs from payer perspective, prescribed medications, and re-fractures were investigated within 6 and 12 months. We used weighted gamma and two-part models and applied entropy balancing to account for the lack of randomization. All analyses were stratified per fracture site. RESULTS We observed 206,273 patients within 12-month follow-up, of whom 14,100 were treated in ATZ, 133,353 in OGCM, and 58,820 in other hospitals. Total average inpatient costs per patient were significantly higher in the OGCM and particularly ATZ group for all fracture sites, compared to control group. We did not find significant differences in costs for re-fractures or antiosteoporotic medication for most fracture sites, although antiosteoporotic medication was significantly more often observed in the OGCM and particularly ATZ group for hip, pelvic, and humerus fractures. CONCLUSION The observed healthcare costs were higher in ATZ and OGCM hospitals within 12 months. Antiosteoporotic medication was prescribed more often in both groups for most fracture sites, although the corresponding medication costs did not increase.
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Affiliation(s)
- Claudia Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Clemens Becker
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Espen Henken
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Abstract
Of 4 older adults, 1 will fall each year in the United States. Based on 2020 data from the Centers of Disease Control, about 36 million older adults fall each year, resulting in 32,000 deaths. Emergency departments see about 3 million older adults for fall-related injuries with falls having the ability to cause serious injury such as catastrophic head injuries and hip fractures. One-third of older fall patients discharged from the ED experience one of these outcomes at 3 months.
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Affiliation(s)
- Kalpana N Shankar
- Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Neville House, Boston, MA 02115, USA.
| | - Angel Li
- Department of Emergency Medicine, The Ohio State University, 376 West 10th Avenue, Columbus, OH 43210, USA
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Jiang Y, Zhu Y, Zhang B, Feng D. Characteristics of subsequent contralateral proximal femoral fracture: more convenient access is needed to treat osteoporosis. J Orthop Surg Res 2023; 18:126. [PMID: 36810116 PMCID: PMC9945589 DOI: 10.1186/s13018-023-03621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Patients with proximal femoral fracture (PFF) have high mortality and many complications. Osteoporosis increases the risk of subsequent fractures, leading to subsequent contralateral PFF. This study was performed to analyze the features of individuals with subsequent PFF following surgical therapy of first PFF and to ascertain whether such patients received an examination or treatment of osteoporosis. The reasons for lack of examination or treatment were also analyzed. METHODS This retrospective study involved 181 patients with subsequent contralateral PFF who underwent surgical treatment in Xi'an Honghui hospital from September 2012 to October 2021. The patients' sex, age, hospital day, mechanism of injury, surgical procedure, fracture interval, fracture type, fracture classification, and Singh index of the contralateral hip at the time of the initial and subsequent fractures were recorded. Whether the patients took calcium and vitamin D supplements, used anti-osteoporosis medication, or underwent a dual X-ray absorptiometry (DXA) scan was recorded, as was the start time of each. Patients who had never undergone a DXA scan or received anti-osteoporosis medication took part in a questionnaire. RESULTS The 181 patients in this study comprised 60 (33.1%) men and 121 (66.9%) women. Patients with initial PFF and subsequent contralateral PFF had a median age of 80 years (range 49-96 years) and 82 years (range 52-96 years), respectively. The median fracture interval was 24 (7-36) months. Contralateral fractures occurred at the highest incidence between 3 months and 1 year (28.7%). The Singh index was not significantly different between the two fractures. In 130 (71.8%) patients, the fracture type was the same. No significant difference was found in the fracture type or fracture stability classification. A total of 144 (79.6%) patients had never received a DXA scan or anti-osteoporosis medication. The main reason for not treating osteoporosis further was concern about the safety of drug interactions (67.4%). CONCLUSIONS Patients with subsequent contralateral PFF were of advanced age, had a higher proportion of intertrochanteric femoral fractures, had more severe osteoporosis, and had longer hospital stays. The difficulty managing such patients requires multidisciplinary involvement. Most of these patients were not screened or formally treated for osteoporosis. Advanced-age patients with osteoporosis need reasonable treatment and management.
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Affiliation(s)
- Yuxuan Jiang
- grid.43169.390000 0001 0599 1243Department of Orthopaedic Trauma, Hong Hui Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, 710054 Shaanxi Province China
| | - Yangjun Zhu
- grid.43169.390000 0001 0599 1243Department of Orthopaedic Trauma, Hong Hui Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, 710054 Shaanxi Province China
| | - Binfei Zhang
- grid.43169.390000 0001 0599 1243Department of Joint Surgery, Hong Hui Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, 710054 Shaanxi Province China
| | - Dongxu Feng
- grid.43169.390000 0001 0599 1243Department of Orthopaedic Trauma, Hong Hui Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, 710054 Shaanxi Province China
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Liu M, Yang C, Xu X, Ji S, Pan Y, Han N, Chang S, Sun G. The prognostic value of retinol binding protein in geriatric hip fractures after surgeries: A propensity score matching and 1-year follow-up study. BMC Musculoskelet Disord 2022; 23:1085. [PMID: 36510169 PMCID: PMC9743574 DOI: 10.1186/s12891-022-06068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to explore the predictive value of retinol binding protein (RBP) for outcomes of hip fractures. METHODS Patients with hip fractures who underwent hip surgeries between December 2017 and February 2021 and met the inclusion criteria were analyzed. Propensity score matching was used to reduce the bias of co-factors and ROC curves based on matched populations were created to determine the optimal cutoff point of RBP. The outcomes between patients with low levels of RBP and high levels of RBP were compared. RESULTS Four hundred eighty patients were enrolled in this study and 69 patients died within one year. After a 1:1 PSM, patients with more than 1-year survival had significantly higher RBP (p = 0.013) than those who died within one year, as well as patients divided by 6-months survival (p = 0.012). Logistics analysis showed that low RBP may be an independent risk factor for 3-month survival, 6-month survival, 1-year survival, and 3-month free walking ability. CONCLUSION RBP may be associated with the survival and 3-month walking abilities of patients with hip fractures.
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Affiliation(s)
- Mingchong Liu
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Chensong Yang
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Xian Xu
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Shengchao Ji
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Yutao Pan
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Ning Han
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
| | - Shimin Chang
- grid.24516.340000000123704535Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200092 China
| | - Guixin Sun
- grid.452753.20000 0004 1799 2798Department of Traumatic Surgery, School of Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200092 China
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Huang CB, Hu JS, Tan K, Zhang W, Xu TH, Yang L. Application of machine learning model to predict osteoporosis based on abdominal computed tomography images of the psoas muscle: a retrospective study. BMC Geriatr 2022; 22:796. [PMID: 36229793 PMCID: PMC9563158 DOI: 10.1186/s12877-022-03502-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With rapid economic development, the world's average life expectancy is increasing, leading to the increasing prevalence of osteoporosis worldwide. However, due to the complexity and high cost of dual-energy x-ray absorptiometry (DXA) examination, DXA has not been widely used to diagnose osteoporosis. In addition, studies have shown that the psoas index measured at the third lumbar spine (L3) level is closely related to bone mineral density (BMD) and has an excellent predictive effect on osteoporosis. Therefore, this study developed a variety of machine learning (ML) models based on psoas muscle tissue at the L3 level of unenhanced abdominal computed tomography (CT) to predict osteoporosis. METHODS Medical professionals collected the CT images and the clinical characteristics data of patients over 40 years old who underwent DXA and abdominal CT examination in the Second Affiliated Hospital of Wenzhou Medical University database from January 2017 to January 2021. Using 3D Slicer software based on horizontal CT images of the L3, the specialist delineated three layers of the region of interest (ROI) along the bilateral psoas muscle edges. The PyRadiomics package in Python was used to extract the features of ROI. Then Mann-Whitney U test and the least absolute shrinkage and selection operator (LASSO) algorithm were used to reduce the dimension of the extracted features. Finally, six machine learning models, Gaussian naïve Bayes (GNB), random forest (RF), logistic regression (LR), support vector machines (SVM), Gradient boosting machine (GBM), and Extreme gradient boosting (XGBoost), were applied to train and validate these features to predict osteoporosis. RESULTS A total of 172 participants met the inclusion and exclusion criteria for the study. 82 participants were enrolled in the osteoporosis group, and 90 were in the non-osteoporosis group. Moreover, the two groups had no significant differences in age, BMI, sex, smoking, drinking, hypertension, and diabetes. Besides, 826 radiomic features were obtained from unenhanced abdominal CT images of osteoporotic and non-osteoporotic patients. Five hundred fifty radiomic features were screened out of 826 by the Mann-Whitney U test. Finally, 16 significant radiomic features were obtained by the LASSO algorithm. These 16 radiomic features were incorporated into six traditional machine learning models (GBM, GNB, LR, RF, SVM, and XGB). All six machine learning models could predict osteoporosis well in the validation set, with the area under the receiver operating characteristic (AUROC) values greater than or equal to 0.8. GBM is more effective in predicting osteoporosis, whose AUROC was 0.86, sensitivity 0.70, specificity 0.92, and accuracy 0.81 in validation sets. CONCLUSION We developed six machine learning models to predict osteoporosis based on psoas muscle images of abdominal CT, and the GBM model had the best predictive performance. GBM model can better help clinicians to diagnose osteoporosis and provide timely anti-osteoporosis treatment for patients. In the future, the research team will strive to include participants from multiple institutions to conduct external validation of the ML model of this study.
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Affiliation(s)
- Cheng-Bin Huang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, 325000, China
| | - Jia-Sen Hu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Kai Tan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, 325000, China
| | - Wei Zhang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Tian-Hao Xu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, 325000, China
| | - Lei Yang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, 325000, China. .,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, 325000, China.
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Li Y, Tung KK, Cho YC, Lin SY, Lee CH, Chen CH. Correction: Improved outcomes and reduced medical costs through multidisciplinary co-management protocol for geriatric proximal femur fractures: a one-year retrospective study. BMC Geriatr 2022; 22:504. [PMID: 35701746 PMCID: PMC9199208 DOI: 10.1186/s12877-022-03136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yang Li
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuan-Kai Tung
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Cheng Cho
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-Yi Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Hung Lee
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Hui Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Orthopedics, Changhua Christian Hospital, Changhua, Taiwan. .,, No. 135, Nanxiao St, Changhua County, 50006, Changhua City, Taiwan.
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