Impact of the FLS model on patients with major fracture in Gran Canaria: 2018–2022 experience

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Antonio Naranjo, Cristian Sarmiento, Amparo Molina, Sonia Fuentes, Laura Cáceres, Soledad Ojeda
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引用次数: 0

Abstract

Summary

We analyzed 5396 patients with fragility fracture, their inclusion by the FLS, and prescription of treatment. Thirty-four percent of potential cases were attended by the FLS, and at the healthcare level, the impact of FLS model resulted in an increase of treated patients from 20% in standard care to 41%.

Introduction

Patients with fragility fractures are at high risk of new fractures, with a negative impact on their quality of life, as well as higher mortality and costs for the health system, especially for hip fractures. Less than 20% of patients receive treatment (lifestyle advice, calcium, vitamin D, and bisphosphonate) after a fracture. The fracture liaison service (FLS) is the most effective model for secondary prevention.

Objectives

To analyze the incidence of fragility fractures in the area of Gran Canaria North and the impact of the FLS unit on the prevention of new fractures.

Methods

Patients > 50 years were attended at the emergency department for fractures of the proximal femur, proximal humerus, distal forearm, pelvis, or vertebra during the period 2018–2022 were included. A file was constructed containing demographic data, type of fracture, inclusion in the FLS, and the initiation of treatment to prevent new fractures. A sample of patients not treated at the FLS was selected for estimating the prophylaxis of fractures under standard care management.

Results

A total of 5396 patients were included, 74.2% women, with a mean age of 74 years. After excluding 558 traumatic fractures (10.3%), 318 (5.9%) deaths, and 167 (3.1%) cases due to a lack of criteria, the sample of potential patients who were candidates for FLS was 4353. This represented 80.6% of the initial sample, of which 1497 patients (34.4%) were attended at the unit. Factors independently associated with referral to the FLS were younger age (OR 0.97; 95% CI 0.97–0.98), female sex (OR 2.24; 95% CI 1.91–2.61), and humerus fracture (OR 1.34; 95% CI 1.16–1.55). Treatment to prevent fractures was verified in 1189 patients (79.4%) in the FLS group and in 585 (20.4%) of those with fragility fractures who were not included. At the healthcare level, the services provided by the FLS resulted in an increase in treated patients from 20% in standard care to 41% with the FLS model.

Conclusions

In terms of treatment initiation to new fracture prevention at the healthcare level, the FLS achieved a twofold increase. The high incidence of fractures and the progressive aging of the population underline the effectiveness of the FLS secondary prevention model.

FLS模型对大加那利岛大骨折患者的影响:2018-2022经验
我们分析了5396例脆性骨折患者,他们被FLS纳入,以及治疗处方。34%的潜在病例接受了FLS治疗,在医疗保健水平上,FLS模型的影响导致接受治疗的患者从标准治疗的20%增加到41%。易碎性骨折患者发生新骨折的风险很高,对其生活质量有负面影响,死亡率和卫生系统费用也较高,尤其是髋部骨折。不到20%的患者在骨折后接受治疗(生活方式建议、补钙、维生素D和双膦酸盐)。裂缝联络服务(FLS)是最有效的二级预防模式。目的分析北加那利岛地区脆性骨折的发生率及FLS装置对预防新发骨折的影响。方法纳入2018-2022年期间在急诊科就诊的50岁以上股骨近端、肱骨近端、前臂远端、骨盆或椎体骨折患者。建立了一个包含人口统计数据、骨折类型、纳入FLS和开始治疗以防止新骨折的文件。选择未在FLS治疗的患者样本,以评估标准护理管理下骨折的预防作用。结果共纳入5396例患者,女性占74.2%,平均年龄74岁。在排除558例外伤性骨折(10.3%)、318例死亡(5.9%)和167例(3.1%)由于缺乏标准而导致的病例后,FLS的潜在候选患者样本为4353例。这代表了初始样本的80.6%,其中1497名患者(34.4%)在该单位就诊。与转介到FLS独立相关的因素是:年龄较小(OR 0.97;95% CI 0.97-0.98),女性(OR 2.24;95% CI 1.91-2.61),肱骨骨折(OR 1.34;95% ci 1.16-1.55)。FLS组1189例(79.4%)患者和未纳入的585例(20.4%)易碎性骨折患者接受了预防骨折的治疗。在医疗保健层面,FLS提供的服务使接受治疗的患者从标准护理的20%增加到FLS模式的41%。结论从保健层面预防新发骨折的治疗开始来看,FLS达到了2倍的增长。骨折的高发生率和人口的逐步老龄化强调了FLS二级预防模式的有效性。
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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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