METHODS: Patients aged 50 years and over hospitalised with a vertebral fragility fracture from 1/2/2016 to 31/1/2017 were identified from radiology and hospital records. Patients sustaining vertebral fractures due to either major trauma or malignancy were excluded. Data was collected on patient demographics, fracture details, hospitalisation details and health outcomes.
RESULTS: 208 patients with acute vertebral fragility fractures were hospitalised over a 12 month period. The mean (SD) age was 80.5 (11) years, of which 68% were female. 94% presented to the Emergency Department (ED) as their first point of contact, of which 70% were subsequently hospitalised. Two-thirds presented with a single level vertebral fracture predominantly around the thoracolumbar region. The majority (87%) were non-operatively managed by general physicians, of which most were under Geriatric Medicine. The median length of stay was 12 (IQR 6-20) days and inpatient mortality was 3%. 52% of patients went on to have a bone health assessment.
CONCLUSION: We have reported on the number of patients presenting to hospital with an acute vertebral fragility fracture over 12 months. This helps identify resources needed to design hospital services to manage them adequately.
METHODS: This study enrolled 147 SLE patients from the Asia Pacific Lupus Collaboration (APLC) cohort, who had BMD and TBS assessed from January 2018 until December 2018. Twenty-eight patients sustaining VF and risk factors associated with increased fracture occurrence were evaluated. Independent risk factors and diagnostic accuracy of VF were analyzed by logistic regression and ROC curve, respectively.
RESULT: The prevalence of vertebral fracture among SLE patients was 19%. BMD, T-score, TBS, and TBS T-score were significantly lower in the vertebral fracture group. TBS exhibited higher positive predictive value and negative predictive value than L spine and left femur BMD for vertebral fractures. Moreover, TBS had a higher diagnostic accuracy than densitometric measurements (area under curve, 0.811 vs. 0.737 and 0.605).
CONCLUSION: Degraded microarchitecture by TBS was associated with prevalent vertebral fractures in SLE patients. Our result suggests that TBS can be a complementary tool for assessing vertebral fracture prevalence in this population.