Göğüs cerrahisi hasta popülasyonunda osteoporoz sıklığı: Toraks bilgisayarlı tomografi tetkiklerinden fırsatçı değerlendirme

Year 2023, Volume: 28 Issue: 1, 81 - 88, 20.01.2023

Mahmut Subaşı Abdulkadir Eren

https://doi.org/10.21673/anadoluklin.1145900

Abstract

Amaç: Göğüs cerrahisi hastalarında osteoporoz sıklığını araştırmak ve doktorlar için klinik önemini vurgulamak.

Yöntemler: 306 hastanın toraks bilgisayarlı tomografileri (BT) T12 vertebra medüller yoğunluğu (Hounsfield unit-HU) açısından incelendi. Erkekler ve kadınlar; “70 yaş altı” ve “70 yaş ve üzeri” gruplar karşılaştırıldı. Yaş parametresinin osteoporozu öngörmedeki tanısal performansını değerlendirmek için alıcı işlem karakteristikleri (receiver operating characteristic-ROC) analizi ve lojistik regresyon analizi kullanıldı. Bu çalışma grubunda tespit edilen kosta kortikal defektleri ve nedenleri açıklandı.

Bulgular: 51 hastanın (veya %16,7) HU’ları 110’un altında idi (osteoporoz); 177’sinin (%57,8) 160’ın üzerindeydi (normal). 78 kişi (%25,5) için HU değerleri 111 ila 159 (sınır) arasında değişmekte idi. Erkekler ve kadınlar arasında anlamlı bir fark yoktu. 70 yaş altı nüfus ile 70 yaş üstü nüfus arasındaki farkın istatistiksel olarak anlamlı olduğu belirlendi (p<0,001). Osteoporozu tahmin etmek için yaş, 0.857’lik bir eğri altında kalan alan (CI 0.806-0.908) sergiledi. Osteoporozun yüzde 95,7 doğruluk oranıyla (p<0,001) yaşa göre doğru bir şekilde öngörüldüğü gösterildi. Kadınlarda eşik değer 57, erkeklerde 55 idi. 6 kişide BT taramalarında kosta korteks defektleri görülürken 2 hastada ise ameliyat sırasında kırık meydana geldi.

Sonuç: Bu popülasyonun yalnızca %57,8’i normal aralıkta kemik yoğunluğuna sahipti. Yaş, osteoporozu öngörmede yüksek doğruluk ile değerli bir parametre olabilir. Kadınlarda 57, erkeklerde 55 yaş üstü osteoporoz varlığı değerlendirilmeli, operasyon ve postoperatif bakım sırasında kemikleri korumaya yönelik önlemler alınmalıdır. 

Keywords

Göğüs cerrahisi, osteoporoz, tomografi

Supporting Institution

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The frequency of osteoporosis in the thoracic surgery patient population: An opportunity assessment from thorax computed tomography scans

Abstract

Aim: To investigate the frequency of osteoporosis in thoracic surgery patients and highlight the clinical significance for physicians.

Methods: Thoracic computed tomographies (CT) of 306 patients were examined for medullary density of the T12 vertebra. Men and women, as well as those under 70 and over 70, were compared in terms of Hounsfield units (HU). To evaluate the diagnostic performance of the age parameter in predicting osteoporosis, receiver operating characteristic (ROC) analysis, and logistic regression analysis were used. The rib cortical defects identified in this study group and their causes were explained.

Results: HUs of 51 subjects (or 16.7%) were less than 110 (osteoporosis); 177 people (57.8%) were higher than 160 (normal). HU values ranged from 111 to 159 (borderline) for 78 individuals (25.5%). There was no significant difference between males and females. It was discovered that the difference between the population under 70 and the population over 70 was statistically significant (p<0.001). For predicting osteoporosis, the age exhibited an area under the curve of 0.857 (CI 0.806-0.908). The threshold value was 57 for women and 55 for men. Osteoporosis was shown to be accurately predicted by age with a 95.7 percent accuracy rate (p<0.001). Six patients were determined to have rib cortical defects seen on CT scans during the evaluation for osteoporosis, and two more patients had fractures noted during surgery.

Conclusion: Within the 306 patients, only 57.8% had bone density within the normal range. The age parameter is valuable with high accuracy (95%) in predicting osteoporosis. The presence of osteoporosis over the age of 57 in women and over 55 in men should be evaluated and measures should be taken to protect the bones during the operation and postoperative care. 

Keywords

Osteoporosis, thoracic surgery, tomography

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