ABSTRACT
BACKGROUND: Age and weight are not only strong predictive parameters for osteoporosis diagnosis but can also be easily acquired from patients. This study aimed to develop and validate a new diagnostic screening model for postmenopausal osteoporosis that uses only 2 parameters, viz., age and weight. The discriminative ability of the model was analyzed and compared with that of the osteoporosis self-assessment tool for Asians (OSTA) index. METHODS: The age-weight diagnostic screening model was developed using a retrospective chart review of postmenopausal women aged ≥50 years who underwent dual energy X-ray absorptiometry at a tertiary hospital from November 2017 to April 2022. Logistic regression analysis was used to derive a diagnostic screening model for osteoporosis. RESULTS: A total of 533 postmenopausal women were included in the study. According to the highest Youden index value, a probability cut-off value of 0.298 was used in the diagnosis screening model at any site, which yielded a sensitivity of 84.3% and a specificity of 53.8%. For increased sensitivity as a screening tool, a cut-off value of 0.254 was proposed to obtain a sensitivity of 90.2% and a specificity of 42.2%. The area under receiver operating characteristic curves from all screening models were significantly higher than those from the OSTA index model (p<0.05). CONCLUSIONS: This study showed the feasibility of a postmenopausal osteoporosis diagnostic screening model that uses 2 strong predictors for osteoporosis diagnosis: age and weight. This age-weight diagnostic model is a simple, effective option in postmenopausal osteoporosis screening.
ABSTRACT
BACKGROUND: The prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibial components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in patients undergoing primary TKA need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA. METHODS: A cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes of osteoporosis were excluded. RESULTS: The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs 230.0 ml, P = 0.003; 282.5 ml vs 240.0 ml, P = 0.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P = 0.014, 0.022, and 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume. CONCLUSIONS: The relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.
