Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study

Author:

Ullrich Bernhard W.12ORCID,Schnake Klaus John34,Schenk Philipp5,Katscher Sebastian6,Bäumlein Martin7,Zimmermann Volker8,Schwarz Falko9,Schmeiser Gregor10ORCID,Scherer Michael11,Müller Michael12,Sprengel Kai13ORCID,Liepold Katja14,Schramm Simon15,Baron Hagen-Christopher16,Siekmann Holger17,Franck Alexander18,Scheyerer Max J.19ORCID,Kirtas Seyma1,Spiegl Ulrich J. A.20,Osterhoff Georg20ORCID,

Affiliation:

1. Department of Trauma and Reconstructive Surgery, BG Clinic Bergmannstrost Halle, Germany

2. Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University, Jena, Germany

3. Center for Spinal and Scoliosis Surgery, Waldkrankenhaus Erlangen, Germany

4. Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Germany

5. Department of Science, Research and Education, BG Clinic Bergmannstrost Halle, Germany

6. Department of Spine Surgery and Neurotraumatology, Sana Klinikum Borna, Borna, Germany

7. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen-Marburg, Germany

8. Department of Trauma and Orthopedic Surgery, Klinikum Traunstein, Germany

9. Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Germany

10. Department of Spine Surgery, Schoen-Clinic Hamburg Eilbek, Hamburg

11. Medical Faculty Technical University of Munich, Germany

12. Department of Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Germany

13. Hirslanden Clinic St Anna, University of Lucerne, Lucerne, Switzerland; Department of Trauma, University Hospital Zurich (USZ), University of Zurich (UZH), Switzerland

14. Department of Spine Surgery, Thuringia Clinic “Georgius Agricola” Saalfeld, Teaching Hospital of the University of Jena, Germany

15. Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Germany

16. Department for Paraplegia and Spine Surgery, BG Clinic Tuebingen, Tuebingen, Germany

17. Clinic of Trauma- Hand- and Reconstruction Surgery, AMEOS-Clinic Halberstadt, Germany

18. Department of Trauma Surgery and Orthopedics, Regiomed Clinical Center Coburg, Germany

19. Faculty of Medicine and University Hospital Cologne, Department of Orthopaedic and Traumatology, University of Cologne, Germany

20. Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Germany

Abstract

Study Design Multicenter prospective cohort study. Objective The study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF). Methods This is a prospective multicenter cohort study (EOFTT) in 17 spine centers. All consecutive patients with OVCF were included. The decision for conservative or surgical therapy was made by the treating physician independent of the OF score recommendation. Final decisions were compared to the recommendations given by the OF score. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5 L, and Barthel Index. Results In total, 518 patients (75.3% female, age 75 ± 10) years were included. 344 (66%) patients received surgical treatment. 71% of patients were treated following the score recommendations. For an OF score cut-off value of 6.5, the sensitivity and specificity to predict actual treatment were 60% and 68% (AUC .684, P < .001). During hospitalization overall 76 (14.7%) complications occurred. The mean follow-up rate and time were 92% and 5 ± 3.5 months, respectively. While all patients in the study cohort improved in clinical outcome parameters, the effect size was significantly less in the patients not treated in line with the OF score’s recommendation. Eight (3%) patients needed revision surgery. Conclusions Patients treated according to the OF score’s recommendations showed favorable short-term clinical results. Noncompliance with the score resulted in more pain and impaired functional outcome and quality of life. The OF score is a reliable and save tool to aid treatment decision in OVCF.

Publisher

SAGE Publications

Subject

Neurology (clinical),Orthopedics and Sports Medicine,Surgery

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