骨质疏松症患者骨折预防知信行调查及胸腰椎骨折的因素分析OA

Objective To investigate the knowledge,belief,and behaviors of fracture prevention in patients with osteoporosis(OP),and to analyze the risk factors of thoracolumbar fractures in patients with OP.Methods This was a cross-sectional survey study.A total of 320 patients with OP admitted to Outpatient Department,Zhengzhou Orthopedic Hospital from February 2020 to November 2022 were selected as the research objects,including 179 males and 141 females who were 45-78 years old.The levels of knowledge,belief,and behaviors of fracture prevention in the patients were investigated by questionnaire.The patients were divided into a thoracolumbar fractures group(35 cases)and a non-thoracolumbar fractures group(285 cases)according to the occurrence of thoracolumbar fractures.The scores of knowledge,belief,and behaviors,heights,weights,and bone mineral densities(BMD)were compared between the two groups by the t test.The good rates of knowledge,belief,and behaviors,and proportions of the patients with different genders and ages,diabetes,coronary heart disease,smoking history,drinking history,previous brittle fracture history,parental fracture history,and glucocorticoid treatment history were compared between the two groups by the x2 test.The risk factors for thoracolumbar fractures in the patients were analyzed by the logistic regression analysis.Results The total scores of knowledge,belief,and behavior dimensions of fracture prevention in the patients were(16.12±3.12),(129.02± 17.50),and(22.02±6.12),respectively.The good rates of knowledge mastery,belief,and behaviors in the patients were 66.88％(214/320),64.22％(411/640),and 53.96％(518/960),respectively.The total scores of knowledge,belief,and behavior dimensions in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group[(12.54±4.12)vs.(16.56±3.00),(117.51± 16.35)vs.(130.43±17.64),and(18.34±3.11)vs.(22.47±6.49)],with statistical differences(t=7.15,4.12,and 3.71;all P＜0.05).The good rates of knowledge mastery,belief,and behaviors in the thoracolumbar fracture group were lower than those in the non-thoracolumbar fracture group[40.00％(14/35)vs.70.18％(200/285),34.29％(24/70)vs.67.89％(387/570),and 28.57％(30/105)vs.57.08％(488/640)],with statistical differences(x2=12.81,30.65,and 30.59;all P＜0.05).The proportions of women,the patients ≥65 years old,and the patients with alcohol consumption history,previous brittle fracture history,and glucocorticoid treatment history in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group,with statistical differences(x2=4.05,11.73,4.36,5.73,and 4.65;all P＜0.05).The BMD of the thoracolumbar fracture group was lower than that of the non-thoracolumbar spine fracture group,with a statistical difference(t=5.55,P＜0.05).The results of logistic regression analysis showed that women[odds ratio(OR)=3.047,95％confidence interval(95％CI)2.456-4.412],age ≥65 years(OR=5.977,95％CI 2.657-7.025),history of alcohol consumption(OR=1.883,95％CI=1.236-2.012),history of brittle fractures(OR=1.919,95％CI 1.658-2.365),and history of glucocorticoid therapy(OR=1.508,95％CI 1.136-1.789)were all risk factors for thoracolumbar fractures in the patients(all P＜0.05),while the BMD was a protective factor(OR=0.421,95％CI 0.211-0.741,P＜0.05).Conclusions The levels of knowledge,belief,and behaviors of fracture prevention in patients with OP need to be improved.Women,age ≥65 years,alcohol consumption history,previous history of brittle fractures,and history of glucocorticoid therapy are all risk factors for thoracolumbar fractures in patients with OP,and BMD is a protective factor.