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Frajilite Kırıklı Osteoporozlu Hastalarımızın Klinik ve Demografik Özellikleri

Yıl 2023, Cilt: 6 Sayı: 2, 242 - 247, 30.06.2023

Öz

Amaç: Frajilite kırıklarındaki yüksek tekrarlama riski ve mortalite oranı nedeniyle, çalışmamızda kliniğimizde değerlendirilen frajilite kırıklı bireylerin özelliklerini araştırmayı amaçladık.
Yöntem: Son 2 yıl içerisinde vertebra, ön kol, proksimal humerus ve kalçasında frajilite kırığı olan 50 yaş üstündeki erkek ve postmenapozal kadın hastaların dosyaları retrospektif olarak incelendi.
Bulgular: 121 hastanın 86’sı (%71,1) kadın, 35’i (%28,9) erkekti ve hastaların yaş ortalaması 68,49±9,85 idi. Hastaların 36’sının (%29,8) kırık yeri kalça, 35’inin (%28,9) ön kol, 26’sının (%21,5) vertebra, 21’inin (%17,4) proksimal humerusken; 3 (%2,5) hastada multiple kırık mevcuttu. 25 (%20,6) hastada daha önce geçirilmiş frajilite kırığı vardı 22 (%18,2) hastada diyette yeterli kalsiyum, 47 (%38,8) hastada diyette yeterli protein alımı mevcuttu. 16 (%13,2) hastanın ebeveyninde kalça kırığı vardı. Hastaların 52 (%43)’sinde osteoporoz riskini artıran komorbidite, 62 (%51,2)’sinde osteoporoz riskini artıran ilaç kullanımı vardı. 92 (%76) hasta kırık sırasında herhangi bir osteoporoz tedavisi almamaktaydı, 5 (%4,1) hastada ise medikal tedavi altındayken kırık gelişmişti. Hastaların 25(OH)VitD3 ortancası 16,5 μg/L (3,0/156,0) idi. Kemik mineral yoğunluğu değerlendirmelerinde femur boyun T skoru ortancası -1,5 (-4,2/2,2), femur total T skoru ortancası -1,0 (-4,1/0,90), lomber total T skoru ortancası -2,2 (-4,3/2,6) idi.
Sonuç: Frajilite kırıkları ile ilişkili faktörlerin bilinmesi yüksek riskli kişilerin belirlenebilmesini kolaylaştıracak, alınacak koruyucu önlemler ve sistematik yaklaşımlar açısından da fikir verecektir.

Kaynakça

  • 1. Cosman F, de Beur SJ, LeBoff MS, et al. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25:2359-2381. doi:10.1007/s00198-014-2794-2
  • 2. Van Geel CM, Van Helden S, Geusens PP, Winkens B, Dinant G-J, Rheum A. Clinical subsequent fractures cluster in time after first fractures Concise report. Ann Rheum Dis. 2009;68:99-102. doi:10.1136/ard.2008.092775
  • 3. Van Staa TP, Dennison EM, Leufkens HGM, Cooper C. Epidemiology of fractures in England and Wales. Bone. 2001;29(6):517-522. doi:10.1016/s8756-3282(01)00614-7
  • 4. Wright NC, Looker AC, Saag KG, et al. The Recent Prevalence of Osteoporosis and Low Bone Mass in the United States Based on Bone Mineral Density at the Femoral Neck or Lumbar Spine. J Bone Miner Res. 2014;29(11):2520-2526. doi:10.1002/jbmr.2269
  • 5. Mohd-Tahir NA, Li SC. Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int. 2017;28:2035-2044. doi:10.1007/s00198-017-3985-4
  • 6. Tuzun S, Eskiyurt N, Akarirmak U, et al. Turkish Osteoporosis Society. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int. 2012;23:949-955. doi:10.1007/s00198-011-1655-5
  • 7. Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int. 2009;20:1633-1650. doi:10.1007/s00198-009-0920-3
  • 8. Tran O, Silverman S, Xu X, et al. Long-term direct and indirect economic burden associated with osteoporotic fracture in US postmenopausal women. Osteoporos Int. 2021;32(6):1195-1205. doi:10.1007/s00198-020-05769-3
  • 9. Lyles KW, Colón-Emeric CS, Magaziner JS, et al. Zoledronic acid in reducing clinical fracture and mortality after hip fracture. N Engl J Med. 2007;357:1799-1809. doi:10.1056/NEJMoa074941
  • 10. Curtis EM, Woolford S, Holmes C, Cooper C, Harvey NC. General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal. Curr Osteoporos Rep. 2020;18(1):38–46. doi:10.1007/s11914-020-00566-7
  • 11. Ulusoy A, Demiröz S. Mechanisms and Causes of Osteoporotic Hip Fractures in Elderly Patients. Turk J Osteoporos. 2020;26(1):19-22. doi:10.4274/tod.galenos.2019.05914
  • 12. Mussolino ME, Looker AC, Madans JH, Langlois JA, Orwoll ES. Risk factors for hip fracture in white men: The NHANES I Epidemiologic Follow-up Study. J Bone Min Res. 1998;13:918-924. doi:10.1359/jbmr.1998.13.6.918
  • 13. Farahmand BY, Michaëlsson K, Baron JA, Persson PG, Ljunghall S. Body size and fracture risk. Swedish Hip Fracture Study Group. Epidemiology 2000;11(2):214-219. doi:10.1097/00001648-200003000-00022
  • 14. Wardlaw GM. Putting body weight and osteoporosis into perspective. Am J Clin Nutr. 1996;63:433-436. doi:10.1093/ajcn/63.3.433
  • 15. Yılmaz A, Yıldızgören MT, Oral Ş, Serarslan Y. Osteoporotik Kırık Nedeniyle Kifoplasti Uygulanan Hastaların Klinik ve Demografik Özellikleri. Turk J Osteoporos. 2017;23:103-106. doi:10.4274/tod.76598
  • 16. Batteux B, Bennis Y, Bodeau S, et al. Associations between osteoporosis and drug exposure: A post-marketing study of the World Health Organization pharmacovigilance database (VigiBase®). Bone. 2021;153:116-117. doi:10.1016/j.bone.2021.116137
  • 17. Wilson-Barnes SL, Lanham-New SA, Lambert H. Modifiable risk factors for bone health & fragility fractures. Best Pract Res Clin Rheumatol. 2022;101758. doi:10.1016/j.berh.2022.101758
  • 18. Adachi JD, Brown JP, Schemitsch E, et al. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada. BMC Musculoskelet Disord. 2021;22(1):224. doi:10.1186/s12891-021-04051-9
  • 19. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15:721-739. doi:10.1359/jbmr.2000.15.4.721
  • 20. Dang DY, Zetumer S, Zhang AL. Recurrent Fragility Fractures: A Cross-sectional Analysis. J Am Acad Orthop Surg. 2019;15:27(2):85-91. doi:10.5435/JAAOS-D-17-00103
  • 21. Sriruanthong K, Philawuth N, Saloa S, Daraphongsataporn N, Sucharitpongpan W. Risk factors of refracture after a fragility fracture in elderly. Arch Osteoporos. 2022;17(1):98. doi:10.1007/s11657-022-01143-4
  • 22. Viprey M, Caillet P, Canat G, et al. Low Osteoporosis Treatment Initiation Rate in Women after Distal Forearm or Proximal Humerus Fracture: A Healthcare Database Nested Cohort Study. PLoS One. 2015;10(12):0143842. doi:10.1371/journal.pone.0143842
  • 23. Baklacıoğlu HŞ, İçağasıoğlu A, Yumuşahkuylu Y, et al. Osteoporoz hastalarında kırığın yaşam kalitesine etkisi ve kırıkla ilişkili faktörler. Göztepe Tıp Dergisi. 2011;26 (1):14-20. doi:10.5222/J.GOZTEPETRH.2011.14
  • 24. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence ofosteoporotic fractures. BMJ. 1996;312:1254-1259. doi:10.1136/bmj.312.7041.1254
  • 25. Jergas M, Glüer CC. Assessment of fracture risk by bone density measurements. Semin Nucl Med. 1997;27:261-275. doi:10.1016/s0001-2998(97)80028-1
  • 26. Cranney A, Jamal SA, Tsang JF, Josse RG, Leslie WD. Low bone mineral density and fracture burden in postmenopausal women. CMAJ. 2007;177:575-580. doi:10.1503/cmaj.070234
  • 27. Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787-2793. doi:10.1210/jc.2004-1568
  • 28. Luc M, Corriveau H, Boire G, et al. Implementing a fracture follow-up liaison service: perspective of key stakeholders. Rheumatol Int. 2020;40(4):607-614. doi:10.1007/s00296-019-04413-6
Yıl 2023, Cilt: 6 Sayı: 2, 242 - 247, 30.06.2023

Öz

Kaynakça

  • 1. Cosman F, de Beur SJ, LeBoff MS, et al. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25:2359-2381. doi:10.1007/s00198-014-2794-2
  • 2. Van Geel CM, Van Helden S, Geusens PP, Winkens B, Dinant G-J, Rheum A. Clinical subsequent fractures cluster in time after first fractures Concise report. Ann Rheum Dis. 2009;68:99-102. doi:10.1136/ard.2008.092775
  • 3. Van Staa TP, Dennison EM, Leufkens HGM, Cooper C. Epidemiology of fractures in England and Wales. Bone. 2001;29(6):517-522. doi:10.1016/s8756-3282(01)00614-7
  • 4. Wright NC, Looker AC, Saag KG, et al. The Recent Prevalence of Osteoporosis and Low Bone Mass in the United States Based on Bone Mineral Density at the Femoral Neck or Lumbar Spine. J Bone Miner Res. 2014;29(11):2520-2526. doi:10.1002/jbmr.2269
  • 5. Mohd-Tahir NA, Li SC. Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int. 2017;28:2035-2044. doi:10.1007/s00198-017-3985-4
  • 6. Tuzun S, Eskiyurt N, Akarirmak U, et al. Turkish Osteoporosis Society. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int. 2012;23:949-955. doi:10.1007/s00198-011-1655-5
  • 7. Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int. 2009;20:1633-1650. doi:10.1007/s00198-009-0920-3
  • 8. Tran O, Silverman S, Xu X, et al. Long-term direct and indirect economic burden associated with osteoporotic fracture in US postmenopausal women. Osteoporos Int. 2021;32(6):1195-1205. doi:10.1007/s00198-020-05769-3
  • 9. Lyles KW, Colón-Emeric CS, Magaziner JS, et al. Zoledronic acid in reducing clinical fracture and mortality after hip fracture. N Engl J Med. 2007;357:1799-1809. doi:10.1056/NEJMoa074941
  • 10. Curtis EM, Woolford S, Holmes C, Cooper C, Harvey NC. General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal. Curr Osteoporos Rep. 2020;18(1):38–46. doi:10.1007/s11914-020-00566-7
  • 11. Ulusoy A, Demiröz S. Mechanisms and Causes of Osteoporotic Hip Fractures in Elderly Patients. Turk J Osteoporos. 2020;26(1):19-22. doi:10.4274/tod.galenos.2019.05914
  • 12. Mussolino ME, Looker AC, Madans JH, Langlois JA, Orwoll ES. Risk factors for hip fracture in white men: The NHANES I Epidemiologic Follow-up Study. J Bone Min Res. 1998;13:918-924. doi:10.1359/jbmr.1998.13.6.918
  • 13. Farahmand BY, Michaëlsson K, Baron JA, Persson PG, Ljunghall S. Body size and fracture risk. Swedish Hip Fracture Study Group. Epidemiology 2000;11(2):214-219. doi:10.1097/00001648-200003000-00022
  • 14. Wardlaw GM. Putting body weight and osteoporosis into perspective. Am J Clin Nutr. 1996;63:433-436. doi:10.1093/ajcn/63.3.433
  • 15. Yılmaz A, Yıldızgören MT, Oral Ş, Serarslan Y. Osteoporotik Kırık Nedeniyle Kifoplasti Uygulanan Hastaların Klinik ve Demografik Özellikleri. Turk J Osteoporos. 2017;23:103-106. doi:10.4274/tod.76598
  • 16. Batteux B, Bennis Y, Bodeau S, et al. Associations between osteoporosis and drug exposure: A post-marketing study of the World Health Organization pharmacovigilance database (VigiBase®). Bone. 2021;153:116-117. doi:10.1016/j.bone.2021.116137
  • 17. Wilson-Barnes SL, Lanham-New SA, Lambert H. Modifiable risk factors for bone health & fragility fractures. Best Pract Res Clin Rheumatol. 2022;101758. doi:10.1016/j.berh.2022.101758
  • 18. Adachi JD, Brown JP, Schemitsch E, et al. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada. BMC Musculoskelet Disord. 2021;22(1):224. doi:10.1186/s12891-021-04051-9
  • 19. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15:721-739. doi:10.1359/jbmr.2000.15.4.721
  • 20. Dang DY, Zetumer S, Zhang AL. Recurrent Fragility Fractures: A Cross-sectional Analysis. J Am Acad Orthop Surg. 2019;15:27(2):85-91. doi:10.5435/JAAOS-D-17-00103
  • 21. Sriruanthong K, Philawuth N, Saloa S, Daraphongsataporn N, Sucharitpongpan W. Risk factors of refracture after a fragility fracture in elderly. Arch Osteoporos. 2022;17(1):98. doi:10.1007/s11657-022-01143-4
  • 22. Viprey M, Caillet P, Canat G, et al. Low Osteoporosis Treatment Initiation Rate in Women after Distal Forearm or Proximal Humerus Fracture: A Healthcare Database Nested Cohort Study. PLoS One. 2015;10(12):0143842. doi:10.1371/journal.pone.0143842
  • 23. Baklacıoğlu HŞ, İçağasıoğlu A, Yumuşahkuylu Y, et al. Osteoporoz hastalarında kırığın yaşam kalitesine etkisi ve kırıkla ilişkili faktörler. Göztepe Tıp Dergisi. 2011;26 (1):14-20. doi:10.5222/J.GOZTEPETRH.2011.14
  • 24. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence ofosteoporotic fractures. BMJ. 1996;312:1254-1259. doi:10.1136/bmj.312.7041.1254
  • 25. Jergas M, Glüer CC. Assessment of fracture risk by bone density measurements. Semin Nucl Med. 1997;27:261-275. doi:10.1016/s0001-2998(97)80028-1
  • 26. Cranney A, Jamal SA, Tsang JF, Josse RG, Leslie WD. Low bone mineral density and fracture burden in postmenopausal women. CMAJ. 2007;177:575-580. doi:10.1503/cmaj.070234
  • 27. Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787-2793. doi:10.1210/jc.2004-1568
  • 28. Luc M, Corriveau H, Boire G, et al. Implementing a fracture follow-up liaison service: perspective of key stakeholders. Rheumatol Int. 2020;40(4):607-614. doi:10.1007/s00296-019-04413-6
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Zeynep Kıraç Ünal 0000-0002-8139-3971

Ayşe Elif Şen 0000-0003-1395-6346

Yeşim Özge Gündüz 0000-0001-9576-0798

Damla Cankurtaran 0000-0002-6208-3345

Ece Ünlü Akyüz 0000-0003-4718-5981

Yayımlanma Tarihi 30 Haziran 2023
Gönderilme Tarihi 1 Ocak 2023
Kabul Tarihi 24 Mayıs 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 6 Sayı: 2

Kaynak Göster

AMA Kıraç Ünal Z, Şen AE, Gündüz YÖ, Cankurtaran D, Ünlü Akyüz E. Frajilite Kırıklı Osteoporozlu Hastalarımızın Klinik ve Demografik Özellikleri. Acta Med Nicomedia. Haziran 2023;6(2):242-247.

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