Penilaian Osteoporosis Scoring OSTA pada Wanita post menopause Dibandingkan dengan DEXA Sebagai Gold Standard

REYNOLD RACHMAN, Prof. dr.H. Armis, Sp.OT,(K) FICS

2015 | Tesis | SP ORTHOPAEDIK DAN TRAUMATOLOGI

Latar Belakang: Osteoporosis menyebabkan peningkatan kerentanan terjadinya fraktur akibat kerapuhan tulang, dan merupakan salah satu penyebab utama penyebab mortalitas dan morbiditas pada wanita pasca menopause. Di negara berkembang dimana masih terbatasnya fasilitas kesehatan, maka untuk mencari cara mengidentifikasi pasien dengan densitas mineral tulang yang rendah yang memiliki resiko tinggi untuk terjadinya fraktur di kemudian hari. The Osteoporosis Self-Assessment Tool for Asians (OSTA) score telah dikembangkan untuk mengidentifikasi wanita dengan resiko osteoporosis . Instrumen ini dapat digunakan sebagai perangkat skrining pasien dengan resiko tinggi yang akan memperoleh keuntungan dengan pemeriksaan densitas mineral tulang dan terapi lebih awal. OSTA sudah divalidasi di beberapa negara seperti di Singapora, Malaysia, Philipina, Korea, Thailand and China dan memberikan hasil yang memuaskan. Objektif: Untuk menentukan kelayakan OSTA score sebagai perangkat skrining osteoporosis primer pada pasien wanita pasca menopause di RSUP dr.Sardjito Yogyakarta berdasarkan pengukuran BMD femur proksimal. Metode: Penelitian ini merupakan suatu penelitian deskriptif analitik. Dilakukan penilaian OSTA dan pemeriksaan DEXA femur proksimal pada 74 wanita post-menopausal. Analisa statistic menggunakan Statistical Package for Social Science (SPSS) software version 12.0. Statistical significance sebesar 5%. Hasil: Hasil penelitian menunjukan OSTA score memberikan prediksi resiko osteoporosis yang baik berdasarkan hasil pemeriksaan BMD di femur proksimal. Sensitivitas instrument sebesar 94,74 %, spesifisitas 41.82 %, positive predictive value (PPV) 0.36, negative predictive value (NPV) 0.958, dan area dibawah receiver operating characteristic curve (ROC) 0.829 Kesimpulan OSTA score efektif dan memiliki sensitifitas dan spesifisitas yang baik untuk mengidentifikasi risiko osteoporosis pada wanita pasca menopause di RSUP Sardjito Yogyakarta

Background: Osteoporosis causes increased susceptibility to fragility fractures, and is a major cause of morbidity and mortality in post menopausal women. In developing countries where there are meager resources, it will definitely be helpful to search for ways to identify patients with low bone mineral density who have a high risk of future fractures. The Osteoporosis Self-Assessment Tool for Asians (OSTA) score has been developed to identify women at risk of osteoporosis. It can be used as a screening tool for patients at risk who would benefit from bone mineral density measurement and treatment. OSTA has been validated in some countries in Singapore, Malaysia, Philipines, Korea, Thailand and China and given a satisfied result. Objective: To determine performance of the OSTA score as a screening tool for primary osteoporosis among post menopausal women patient in RSUP dr.Sardjito Yogyakarta based on BMD measurements at the proximal femur. Method: This is an analytic descriptive research. 74 post menopausal women were performed OSTA score calculation and DEXA scan of the proximal femur. Statistical analysis was performed using Statistical Package for Social Science (SPSS) software version 12.0. Statistical significance was set at 5%. Result: The results showed that the OSTA score is a good predictor of patients at risk of osteoporosis based on BMD measurements at the proximal femur. Instrument sensitivity was 94,74 %, specificity was 41.82 %, positive predictive value (PPV) was 0.36, negative predictive value (NPV) was 0.958, and the area under the receiver operating characteristic curve (ROC) was 0.829. Conclusion: We conclude that use of the OSTA score in post menopausal women is effective and has adequate sensitivity and specificity for identify the risk of osteoporosis for postmenopausal women in Yogyakarta

Kata Kunci : Osteoporosis, pasca menopause, OSTA