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. 2024 Mar;10(1):16-21.
doi: 10.1016/j.afos.2024.01.003. Epub 2024 Mar 2.

Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery

Keisuke Uemura  1 , Kazuma Takashima  2 , Ryo Higuchi  2 , Sotaro Kono  2 , Hirokazu Mae  2 , Makoto Iwasa  3 , Hirohito Abe  4 , Yuki Maeda  5 , Takayuki Kyo  6 , Takashi Imagama  7 , Wataru Ando  8 , Takashi Sakai  7 , Seiji Okada  2 , Hidetoshi Hamada  1
Affiliations

Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery

Keisuke Uemura et al. Osteoporos Sarcopenia. 2024 Mar.

Abstract

Objectives: Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.

Methods: A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.

Results: DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of -5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.

Conclusions: OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.

Keywords: Dual-energy X-ray absorptiometry; Hip surgery; Osteopenia; Osteosarcopenia; Screening.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Correlation between Osteoporosis Self-assessment Tool for Asians (OSTA) score and DXA-BMD. Red dots indicate patients with proximal femoral fracture while the black dots indicate the non-fracture cases. The regression line is indicated by the blue dotted line. The regression equation, coefficient of determination, and P-value are indicated in red letters.
Fig. 2
Fig. 2
(a) Receiver operating characteristic (ROC) curve for diagnosing osteopenia/osteoporosis (T-score ≤ −1) (a) and osteoporosis (T-score ≤ −2.5) (b) using the Osteoporosis Self-assessment Tool for Asians (OSTA) score. The blue circle indicates the optimal cut-off point.
Fig. 3
Fig. 3
Correlation between OSTA index and the percentages of patients with osteopenia/osteoporosis (T-score ≤ −1) (a) and osteoporosis (T-score ≤ −2.5) (b) at each index. The regression line is indicated by the black dotted line.
See this image and copyright information in PMC

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