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Bone Health Screening Prior to Medicare Eligibility-Osteoporosis Screening and Fracture Prevention After Distal Radius Fractures in Patients Aged 50-59
被引：0
|作者：
Gong, Jung Ho
[1
,2
]
Azad, Chao Long
[1
,3
]
Zhang, Gongliang
[1
,4
]
Aliu, Oluseyi
[3
]
Giladi, Aviram M.
[1
]
机构：
[1] MedStar Union Mem Hosp, Curtis Natl Hand Ctr, 3333 North Calvert St, Baltimore, MD 21218 USA
[2] Brown Univ, Warren Alpert Med Sch, Providence, RI USA
[3] Johns Hopkins Univ Hosp, Dept Plast & Reconstruct Surg, Baltimore, MD USA
[4] MedStar Hlth Res Inst, Hyattsville, MD USA
来源：
关键词：
Bone mineral density;
distal radius fracture;
fragility fracture;
Medicare;
osteoporosis screening;
MINERAL DENSITY;
HIP FRACTURE;
FOREARM;
MEN;
EPIDEMIOLOGY;
MANAGEMENT;
DIAGNOSIS;
SPINE;
WOMEN;
D O I：
10.1016/j.jhsa.2023.10.021
中图分类号：
R826.8 [整形外科学];
R782.2 [口腔颌面部整形外科学];
R726.2 [小儿整形外科学];
R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Purpose Current guidelines recommend bone mineral density (BMD) testing after fragility fractures in patients aged 50 years or older. This study aimed to assess BMD testing and subsequent fragility fractures after low-energy distal radius fractures (DRFs) among patients aged 50-59 years. Methods We used the 2010-2020 MarketScan dataset to identify patients with initial DRFs with ages ranging between 50 and 59 years. We assessed the 1 -year BMD testing rate and 3-year non-DRF fragility fracture rate. We created Kaplan-Meier plots to depict fragility fracture-free probabilities over time and used log-rank tests to compare the Kaplan-Meier curves. Results Among 78,389 patients aged 50-59 years with DRFs, 24,589 patients met our inclusion criteria, and most patients were women (N = 17,580, 71.5%). The BMD testing rate within 1 year after the initial DRF was 12.7% (95% CI, 12.3% to 13.2%). In addition, 1-year BMD testing rates for the age groups of 50-54 and 55-59 years were 10.4% (95% CI, 9.9% to 11.0%) and 14.9% (95% CI, 14.2% to 15.6%), respectively. Only 1.8% (95% CI, 1.5% to 2.1%) of men, compared with 17.1% (95% CI, 16.5% to 17.7%) of women, underwent BMD testing within 1 year after the initial fracture. The overall 3-year fragility fracture rate was 6.0% (95% CI, 5.6% to 6.3%). The subsequent fragility fracture rate was lower for those with any BMD testing (4.4%; 95% CI, 3.7% to 5.2%), compared with those without BMD testing (6.2%; 95% CI, 5.9% to 6.6%; P < .05). Conclusions We report a low BMD testing rate for patients aged between 50 and 59 years after initial isolated DRFs, especially for men and patients aged between 50 and 54 years. Patients who received BMD testing had a lower rate of subsequent fracture within 3 years. We recommend that providers follow published guidelines and initiate an osteoporosis work-up for patients with low-energy DRFs to ensure early diagnosis. This provides an opportunity to initiate treatment that may prevent subsequent fractures. Copyright (c) 2024 by the American Society for Surgery of the Hand. All rights reserved.
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页码：203 / 211
页数：9
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