ArticleFrontiers in medicine2025
Predicting re-fracture risk factors in older adult osteoporotic vertebral fractures patients with comorbidities: development and validation of nomogram.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prediction models for subsequent vertebral fractures after percutaneous vertebroplasty or kyphoplasty: a systematic review and critical appraisal.BMC musculoskeletal disorders · 2026Pooled it
- Integrating core muscle morphology into a predictive model for residual back pain after vertebral augmentation.Frontiers in surgery · 2026Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Osteoporotic vertebral compression fractures (OVCFs) pose a significant health burden in older adult populations, with postoperative re-fracture (re.fra) complicating recovery. Existing models (e.g., FRAX, QFracture) inadequately address comorbidities and modifiable lifestyle factors. This study aimed to develop and validate a novel nomogram integrating these underrecognized yet critical predictors for personalized risk stratification. Methods: A retrospective cohort of 560 older adult OVCF patients undergoing percutaneous vertebroplasty (PVP) was analyzed. Patients were randomly divided into training (70%, Results: Independent predictors included tumor history [adjusted odds ratio (aOR) = 12.29, 95% CI: 2.50-60.35], scoliosis (aOR = 6.46, 95% CI: 2.97-14.03), mental disorders (aOR = 5.91, 95% CI: 2.73-12.82), alcohol use ≥10 years (aOR = 3.69, 95% CI: 1.90-7.17), and chronic kidney disease (aOR = 3.12, 95% CI: 1.61-6.06). Hypertension exhibited a paradoxical protective association (aOR = 0.50, 95% CI: 0.27-0.93). The nomogram demonstrated strong discrimination [AUC:0.886 (training), 0.827 (testing)], excellent calibration in training (slope = 1.000, Brier = 0.118) with slight deviation in testing (slope = 0.697, Brier = 0.162), and superior net benefit over treat-all/none strategies across thresholds (DCA). Conclusion: This validated nomogram integrates often-overlooked comorbidities and lifestyle factors to predict post-PVP re.fra risk, providing a practical tool for personalized management and highlighting the need for multidisciplinary care in high-risk subgroups such as those with scoliosis, mental disorders, or prolonged alcohol use. The intriguing protective association of hypertension, however, requires cautious interpretation and further investigation before clinical application.
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