注册骨折联络服务并不能保证骨折后的随访

IF 3.3 Q1 ENDOCRINOLOGY & METABOLISM
Craig R. Jenkins, Jessica D. Collier, Claire I. Yee, Blake T. Langlais, Jaxon K. Quillen, Patricia M. Verona, Michael D. Whitaker, Curtiss B. Cook
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引用次数: 0

摘要

目的评估一组骨折联络服务(FLS)患者骨折后门诊随访依从性。方法分析2020年6月至2022年12月期间脆性骨折住院患者的FLS登记数据,并确定在门诊内分泌科和骨科诊所随访预约的患者比例。结果:我们确定了295例符合FLS途径的患者;在这一组中,有57人拒绝了内分泌学随访。在剩下的238名患者中,95名(40%)有预约,但后来取消了,7名(3%)没有赴约。77例(32%)患者无随访记录。因此,238人中只有59人(25%)遵守了内分泌科的预约。在单变量分析中,年龄、疾病严重程度和出院状态仅在骨科队列中与随访依从性相关(P≤0.02)。然而,调整后的分析并没有发现任何与内分泌学或骨科队列随访依从性相关的变量。结论与骨科组相比,内分泌组骨折后门诊随访率较低,即使在参加FLS的患者中也是如此。先前假设影响随访的因素,包括本研究中描述的因素,显示与预约遵守行为无关。可能,骨质疏松症治疗的重要性没有被强调,或者治疗方案对我们的患者群体没有吸引力。需要进一步的研究来确定导致骨折后低内分泌随访率的具体障碍。骨折联络服务可以可靠地减少未来的骨折事件,但住院后的随访依从性仍然具有挑战性。我们比较了一组因脆性骨折住院患者的内分泌科随访率与骨科随访率,并评估了可能导致内分泌科随访率较低的变量(如旅行距离、年龄、婚姻状况)。然而,没有发现有显著影响的因素。这些数据表明,之前认为导致骨折后随访率低于预期的具体障碍是有误导性的,需要新的方法来解决这一普遍问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enrollment in a fracture liaison service does not guarantee post fracture follow-up

Objective

To assess post fracture outpatient follow-up adherence in a cohort of patients enrolled in a fracture liaison service (FLS).

Methods

We analyzed FLS registry data for patients who were hospitalized with fragility fractures from June 2020 through December 2022 and determined the proportion of patients who kept their follow-up appointments in outpatient endocrinology and orthopedic clinics.

Results

We identified 295 patients who were eligible for the FLS pathway; from this group, 57 declined an endocrinology follow-up visit. Of the remaining 238 patients, 95 (40 %) had appointments but subsequently canceled and 7 (3 %) did not show up for their appointments. No follow-up information was documented for 77 patients (32 %). Thus, only 59 of 238 (25 %) kept their appointments in endocrinology. In the univariate analyses, age, severity of illness, and discharge status were associated with follow-up adherence only in the orthopedic cohort (P ≤ 0.02). However, the adjusted analyses did not identify any variables that were associated with follow-up adherence in either the endocrinology or orthopedic cohorts.

Conclusion

Post fracture outpatient follow-up was lower for the endocrinology cohort, as compared with the orthopedic cohort, even among patients enrolled in an FLS. Factors that were previously postulated to influence follow-up, including those described in this study, showed no association with appointment-keeping behavior. Possibly, the importance of osteoporosis treatment is not emphasized or the treatment options are unappealing to our patient population. Further study is needed to determine the specific obstacles contributing to the low endocrine post fracture follow-up rate.

Key Message

Fracture liaison services can reliably reduce future fracture events, but follow-up adherence after hospitalization remains challenging. We compared the rates of endocrinology vs orthopedic follow-up in a single cohort of patients hospitalized for fragility fractures and assessed variables that potentially contributed to the lower endocrinology follow-up rate (eg, travel distance, age, marital status). However, no factors were identified as having a significant effect. These data show that the specific obstacles previously thought to contribute to lower-than-expected post fracture follow-up rates are misleading, and novel approaches are needed to address this widespread issue.
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来源期刊
CiteScore
6.10
自引率
0.00%
发文量
24
审稿时长
16 weeks
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