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Ludwigshafener Osteoporosescreeningbogen (LOS-Bogen)

Resultat aus der Evaluation anamnestischer Risikofaktoren in der Osteoporosediagnostik

The Ludwigshafen Osteoporosis Screening Questionnaire (LOS Questionnaire)

Result of the evaluation of anamnestic risk factors in osteoporosis diagnostics

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Zusammenfassung

Hintergrund

Die Osteoporose stellt eine der weltweit führenden Gesundheitsproblematiken dar und wurde daher in die WHO-Liste der 10 schwerwiegendsten Erkrankungen aufgenommen. Trotzdem erfolgt immer noch sehr häufig die Diagnosestellung erst nach stattgehabter erster osteoporotischer Fraktur, was zum einen an der mangelnden Patientenaufklärung, aber auch an der fehlenden Kostenübernahme der Kostenerstatter für frühzeitige Screeningmethoden liegt.

Material und Methoden

In unserer Studie von 78 Patienten mit metaphysären Frakturen langer Röhrenknochen untersuchten wir die Korrelation zwischen anamnestischen Risikofaktoren, sowie knochenspezifischen Stoffwechselparametern als mögliche diagnostische Instrumente und der Knochendichte (BMD „bone morphogenic density“). Zudem soll die hohe Prävelenz der Osteoporose bei Patienten mit metaphysären Frakturen demonstriert werden.

Ergebnisse

In der DXA-Messung („dual X-ray absorption densitometry“) zeigten 43,6% unserer Patienten eine manifeste Osteoporose und 76,9% der Patienten hatten bereits eine verminderte Knochendichte. Unser modifizierter LOS- (Ludwigshafener Osteoporosescreening-)Fragebogen zeigte eine hochsignifikante Korrelation (p=0,01) mit verminderter BMD, wogegen 7 knochenspezifische Laborparameter eine signifikante Korrelation (p=0,046) aufwiesen.

Schlussfolgerung

Anamnestische Risikofaktoren korrelieren stärker mit reduzierter Knochendichte als knochenspezifische Stoffwechselparameter. Der an die Empfehlungen der DVO angelehnte Fragebogen LOS-Bogen kann als kosteneffizientes erstes diagnostisches Instrument für die Identifikation osteoporotischer Patienten dienen.

Abstract

Background

Osteoporosis is a major health problem worldwide and is included in the WHO list of the top ten major diseases. However, it is often undiagnosed until the first fracture occurs, due to inadequate patient education and lack of insurance coverage for screening tests.

Methods and material

In our study of 78 patients with metaphyseal long bone fractures, we searched for a correlation between anamnestic risk factors, bone-specific laboratory values, and the bone morphogenic density (BMD). Each indicator was examined as a possible diagnostic instrument for osteoporosis. The secondary aim of this study was to demonstrate the high prevalence of osteoporosis in patients with metaphyseal fractures.

Results

Of our fracture patients 76.9% had decreased bone density and 43.6% showed manifest osteoporosis in DXA (densitometry) measurements. Our modified LOS Questionnaire, identifying anamnestic risk factors, correlated highly significantly (p=0.01) with reduced BMD, whereas seven bone-specific laboratory values (p=0.046) correlated significantly.

Conclusion

Anamnestic risk factors correlate with pathological BMD more than bone-specific laboratory values. The LOS Questionnaire used in this study would therefore function as a cost-effective primary diagnostic instrument for identification of osteoporosis patients.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67063, Ludwigshafen, Deutschland

    C. Wölfl, C. Takur, A.A. Moghaddam, M. Hitzler & P.A Grützner

  2. Klinik für Unfallchirurgie und Orthopädie, TKM Mannheim, Mannheim, Deutschland

    G. Zimmermann

  3. Klinisches Labor Limbach, Heidelberg, Deutschland

    H. Schmidt-Gayk

  4. SRH-Hochschule, Heidelberg, Deutschland

    B. Höner

  5. Klinik für Plastische-, Rekonstruktive und Handchirurgie, Schwerbrandverletztenzentrum, BG-Unfallklinik Ludwigshafen, Ludwigshafen, Deutschland

    L. Kolios

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  1. C. Wölfl
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  2. C. Takur
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  8. P.A Grützner
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Correspondence to C. Wölfl.

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Wölfl, C., Takur, C., Moghaddam, A. et al. Ludwigshafener Osteoporosescreeningbogen (LOS-Bogen). Unfallchirurg 116, 144–150 (2013). https://doi.org/10.1007/s00113-011-2133-4

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