Decreased mortality in patients with fragility fracture of a fracture liaison service coordinated by Chile's first nurse practitioner.

Abstract

Background: Fragility fractures have significant sequelae, including pain, loss of mobility, and increased risk of mortality. Fracture liaison services (FLS) represent a coordinated, interdisciplinary approach to secondary prevention and reduce mortality.

Purpose: To investigate the effectiveness and patient outcomes regarding readmission and mortality of a newly developed, nurse practitioner (NP) coordinated FLS in Chile.

Methodology: Retrospective longitudinal analysis of 214 patients who agreed to participate in a FLS was conducted. Variables studied include patient age, gender, anatomical fracture site, dual x-ray absorptiometry scans, medication, readmission information, and mortality. Demographics and clinical data were collected and analyzed with bivariate and multivariate statistics. Kaplan-Meier curves and log-rank tests were performed to compare survival curves between those who did and did not participate in the FLS.

Results: The study sample was predominantly female (85%) with a mean age of 76 (SD: 12; range 41-101) years. The most frequently noted fracture sites were hip (n = 167), wrist (n = 132), and spine (n = 72). At one-year follow-up, the FLS group had a significantly lower mortality (5%, 10 patients) than those who did not participate in the program (12% [N = 50], p = .005). The Kaplan-Meier analysis indicated that patients who participated in the FLS had significantly better survival rates than those who did not participate.

Conclusions: Significantly improved survival rates were observed in FLS patients. Chile's first FLS demonstrated improved patient outcomes, specifically a reduced mortality in patients who were enrolled in the FLS.

Implications: The NP role was fundamental in the screening, diagnosis, and treatment of patients with osteoporosis.