Department of Internal Medicine, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
Arch Osteoporos. 2018 Nov 20;13(1):133. doi: 10.1007/s11657-018-0548-z.
Referral patterns for bone mineral density testing by dual energy X-ray absorptiometry (DXA) scanning are seldom studied. In our study, the overall proportion of referrals from specialties remained low. This highlights the need for adequate utilisation of DXA by specialties treating subjects at risk for osteoporosis.
PURPOSE/OBJECTIVES: The knowledge of referral patterns for DXA scanning (dual energy X-ray absorptiometry) for bone mineral density (BMD) measurement is relevant in a developing country like India. We studied the referral source and clinical and densitometric profile of patients referred for DXA scanning at a south Indian tertiary care centre.
We conducted a cross-sectional study over 3 months and included subjects referred during this period for BMD assessment (lumbar spine and femoral neck) by DXA scan. Details regarding referring departments and reasons for referral were collected. The number of patients seen in individual departments was obtained during the study period and respective proportions of patients referred were calculated.
Of the 1932 subjects included in the study, we observed a definite female preponderance (90.2%), with a mean (SD) age of 51.6 (13.3) years. The greatest number of referrals came from the departments of rheumatology (37%; n = 724) and endocrinology (20%; n = 382). Overall, 36% were referred for inflammatory arthritis or systemic inflammatory disorders (n = 696) and 34% for postmenopausal state screening (n = 657). In relation to the individual outpatient strength, the departments who referred the highest proportion of their patients were rheumatology (6.8%), endocrinology (1.76%) and geriatrics (1.05%). A diagnosis of osteoporosis at any one site was made in 41% (448 of 1107) and the BMD was below the expected range for age in 37% (304 of 825) of the referrals.
Most referrals for DXA scanning were from rheumatology. Among the referred patients, about two fifth had osteoporosis and over one third had BMD below expected range for age. Although referrals by rheumatology were relatively higher, overall referrals from all departments remained low. This underscores the need for adequate utilisation of DXA by specialties treating subjects at risk for osteoporosis.
双能 X 射线吸收法（DXA）扫描的骨密度检测的转诊模式很少被研究。在我们的研究中，各专科的转诊比例仍然很低。这凸显了治疗骨质疏松症高危人群的专科医生充分利用 DXA 的必要性。
目的/目标：在印度这样的发展中国家，了解 DXA 扫描（双能 X 射线吸收法）用于骨密度（BMD）测量的转诊模式是很重要的。我们研究了在印度南部一家三级保健中心进行 DXA 扫描的患者的转诊来源、临床和骨密度特征。
我们进行了一项横断面研究，历时 3 个月，纳入在此期间因 BMD 评估（腰椎和股骨颈）而被转诊进行 DXA 扫描的患者。收集了有关转诊科室和转诊原因的详细信息。在研究期间，获得了各科室就诊患者的数量，并计算了各自转诊患者的比例。
在纳入研究的 1932 名患者中，我们观察到明确的女性优势（90.2%），平均（SD）年龄为 51.6（13.3）岁。来自风湿病科（37%；n=724）和内分泌科（20%；n=382）的转诊人数最多。总体而言，36%的患者因炎症性关节炎或全身性炎症性疾病（n=696）和 34%的患者因绝经后状态筛查（n=657）而被转诊。就个别门诊科室的就诊患者比例而言，转诊比例最高的科室是风湿病科（6.8%）、内分泌科（1.76%）和老年科（1.05%）。在任何一个部位诊断为骨质疏松症的患者占 41%（448 例中有 1107 例），BMD 低于预期年龄范围的患者占 37%（304 例中有 825 例）。
大多数 DXA 扫描的转诊来自风湿病科。在转诊患者中，约五分之二患有骨质疏松症，超过三分之一的患者 BMD 低于预期年龄范围。尽管风湿病科的转诊相对较高，但所有科室的总体转诊比例仍然较低。这凸显了治疗骨质疏松症高危人群的专科医生充分利用 DXA 的必要性。
