TÌNH HÌNH ĐIỀU TRỊ LOÃNG XƯƠNG VÀ CÁC YẾU TỐ LIÊN QUAN Ở NGƯỜI CAO TUỔI GÃY XƯƠNG ĐỐT SỐNG

Abstract

Objective: This study aimed to investigate the treatment rate of osteoporosis in elderly patients with vertebral fractures and related factors at the University Medical Center, Ho Chi Minh City. Methods: This cross-sectional study involved 270 elderly patients (≥ 60 years old), at the Rheumatology, Neurosurgery, and Geriatrics outpatient Clinics of the University Medical Center, Ho Chi Minh City from August 2022 to May 2023. The Genant semiquantitative technique was used to diagnose vertebral fractures based on X-rays of thoracic/lumbar spine. Data including demographic information, medical history and clinical examination findings were obtained. The treatment rate of osteoporosis was determined based on the patients medical records and their prescriptions. Results: The treatment rate of osteoporosis prior to vertebral fractures was 16,67% (45/270 patients). However, this rate increased significantly to 78,22% after vertebral fractures in the remaining patients (176/225 patients). The proportion of male elderly patients who were treated with osteoporosis before and after vertebral fractures was lower than that of female elderly patients (6,56% vs 19,62% before vertebral fractures; 59,65% vs 84,52% after vertebral fractures). Multivariate logistic regression analysis revealed that female sex (OR = 3,98, p = 0,007), spondylosis (OR = 2,83, p = 0,019), vertebral fractures in T11 – L5 (OR = 4,80, p = 0,005) were positively associated with the outcome of osteoporosis treatment after vertebral fractures. Conversely, diabetes (OR = 0,37, p = 0,028), chronic kidney disease (OR = 0,28, p = 0,031) and T-score > -2,5 (OR = 0,23, p = 0,001) were negatively associated with the outcome of osteoporosis treatment after vertebral fractures. Conclusion: The proportion of elderly patients treated with osteoporosis prior to vertebral fractures remained low but the treatment rate significantly increased after the diagnosis of vertebral fractures. Elderly patients with female sex, spondylosis and vertebral fractures in T11 –L5 were more likely to be treated with osteoporosis after vertebral fractures. On the contrary, diabetes, chronic kidney disease and T-score > -2,5 were inversely related to the likelihood of receiving osteoporosis treatment after vertebral fractures