Prognostic models for the development of diffuse idiopathic skeletal hyperostosis

Abstract

Introduction: Diffuse idiopathic skeletal hyperostosis (DISH) is a common worldwide disease in adults over 50 years of age. The clinical diagnosis at the beginning of the disease is very difficult, even impossible, without typical symptoms and image changes. Mathematical models for searching risk factors include analysing medical history data, comorbidities, biochemical and instrumental results. Aim: The aim of the study was to analyse the demographic, clinical, biochemical, and imaging findings in patients with DISH and develop prognostic models to help identify risk factors for the disease. Materials and methods: We analysed 124 patients with diffuse idiopathic skeletal hyperostosis treated at the Clinic of Rheumatology in St George University Hospital, Plovdiv between 2013 and 2020. All biochemical and imaging studies were performed in the facilities of the University Hospital. SPSS, ver. 26 was used for the statistical analysis. Results: One-way analysis of history and clinical symptoms showed the highest prognostic value with OR>4 for over 50 years, mechanical pain in the thoracic and cervical spine, and Ott’s symptom, OR >3 for Hirz’s symptom, and OR>2 for thoracic spine stiffness, clinical evidence of spine fracture, and the Shober’s symptom. We found that the highest prognostic value for the risk factors of DISH is elevated triglycerides, increased glucose, increased total cholesterol, and increased uric acid (OR over 5). Conclusions: Our mathematical models determined the risk factors for development of DISH using different variables from the history, laboratory parameters, and imaging studies. These mathematical models are easy to apply and can be used routinely in clinical practice.