Costs of patient management over 18 months following a hip, clinical vertebral, distal forearm, or proximal humerus fragility fracture in France—results from the ICUROS study

2021 ◽  
Author(s):  
Astrid Coassy ◽  
Axel Svedbom ◽  
Hervé Locrelle ◽  
Roland Chapurlat ◽  
Bernard Cortet ◽  
...  
Keyword(s):  
Fragility Fracture ◽  
Patient Management ◽  
Proximal Humerus ◽  
Distal Forearm

Risk Factors for Fractures of the Distal Forearm and Proximal Humerus

1992 ◽  
Vol 135 (5) ◽  
pp. 477-489 ◽  
Author(s):  
Jennifer L. Kelsey ◽  
Warren S. Browner ◽  
Dana G. Seeley ◽  
Michael C. Nevitt ◽  
Steven R. Cummings
Keyword(s):  
Risk Factors ◽  
Proximal Humerus ◽  
Distal Forearm

scholarly journals Quality of life after fragility fracture in the Russian Federation: results from the Russian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (ICUROS)

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Olga Lesnyak ◽  
Axel Svedbom ◽  
Ksenia Belova ◽  
Olga Dobrovolskaya ◽  
Olga Ershova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hip Fracture ◽  
Proximal Humerus ◽  
Forearm Fracture ◽  
Osteoporotic Fractures ◽  
Economic Evaluations ◽  
Distal Forearm ◽  
Distal Forearm Fracture ◽  
Utility Values

Abstract Summary Changes in health-related quality of life (QoL) due to hip, humeral, ankle, spine, and distal forearm fracture were measured in Russian adults age 50 years or more over the first 18 months after fracture. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Introduction Data on QoL following osteoporotic fractures in Russia are scarce. The present study evaluated the impact of hip, vertebral, proximal humerus, distal forearm, and ankle fracture up to 18 months after fracture from the Russian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. Methods Individuals age ≥ 50 years with low-energy-induced humeral, hip, clinical vertebral, ankle, or distal forearm fracture were enrolled. After a recall of pre-fracture status, HRQoL was prospectively collected over 18 months of follow-up using EQ-5D-3L. Multivariate regression analysis was used to identify determinants of QALYs loss. Results At 2 weeks, patients with hip fracture (n = 223) reported the lowest mean health state utility value (HSUV) compared with other fracture sites. Thereafter, utility values increased but remained significantly lower than before fracture. For spine (n = 183), humerus (n = 166), and ankle fractures (n = 214), there was a similar pattern of disutility with a nadir within 2 weeks and a progressive recovery thereafter. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Substantial impairment in self-care and usual activities immediately after fracture were important predictors of recovery across at all fracture sites. Conclusions Fractures of the hip, vertebral, distal forearm, ankle, and proximal humerus incur substantial loss of QoL in Russia. The utility values derived from this study can be used in future economic evaluations.

Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fractures

2003 ◽  
Vol 14 (6) ◽  
pp. 469-475 ◽  
Author(s):  
Theresa H. M. Keegan ◽  
Geetha Gopalakrishnan ◽  
Stephen Sidney ◽  
Charles P. Quesenberry ◽  
Jennifer L. Kelsey
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Proximal Humerus ◽  
Hormone Replacement ◽  
Distal Forearm ◽  
Pelvis Fractures

scholarly journals Effect of chronic kidney disease on outcomes following proximal humerus fragility fracture surgery in diabetic patients: A nationwide population-based cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258393
Author(s):  
Chien-Tien Chen ◽  
Su-Ju Lin ◽  
Liang-Tseng Kuo ◽  
Tien-Hsing Chen ◽  
Wei-Hsiu Hsu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Fragility Fracture ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Perioperative Outcomes ◽  
Diabetic Patients ◽  
Research Database

Background The proximal humerus fracture (PHF) is the third most common fragility fracture. Diabetes mellitus (DM) and chronic kidney disease (CKD) are both risks for fragility fractures; however, the interplay of DM and CKD makes treatment outcomes unpredictable. This study aimed to investigate and compare early and late outcomes following proximal humerus fracture fixation surgery in diabetic patients with different renal function conditions. Methods DM patients receiving PHF fixation surgery during 1998–2013 were recruited from Taiwan’s National Health Insurance Research Database. According to their renal function, patients were divided into three study groups: non-chronic kidney disease (CKD), non-dialysis CKD, and dialysis. Outcomes of interest were early and late perioperative outcomes. Early outcomes included in-hospital newly-onset morbidities. Late outcomes included infection, revision, readmission, and all-cause mortality. Results This study included a total of 10,850 diabetic patients: 2152 had CKD (non-dialysis CKD group), 196 underwent permanent dialysis (dialysis group), and the remaining 8502 did not have CKD (non-CKD group). During a mean follow-up of 5.56 years, the dialysis group showed the highest risk of overall infection, all-cause revision, readmission, and mortality compared to the non-dialysis CKD group and non-CKD group. Furthermore, subgroup analysis showed that CKD patients had a higher risk of surgical infection following PHF surgery than non-CKD patients in cases with a traffic accident or fewer comorbidities (Charlson Comorbidity Index, CCI <3) (P for interaction: 0.086 and 0.096, respectively). Also, CKD patients had an even higher mortality risk after PHF surgery than non-CKD patients, in females, those living in higher urbanization areas, or with more comorbidities (CCI ≥3) (P for interaction: 0.011, 0.057, and 0.069, respectively). Conclusion CKD was associated with elevated risks for infection, revision, readmission, and mortality after PHF fixation surgery in diabetic patients. These findings should be taken into consideration when caring for diabetic patients.

Systematic approaches to fragility fracture prevention

2014 ◽  
Vol 23 (01) ◽  
pp. 39-44
Author(s):  
D. B. Lee ◽  
P. J. Mitchell
Keyword(s):  
Fragility Fracture ◽  
National Policy ◽  
Fragility Fractures ◽  
Fracture Prevention ◽  
The United States ◽  
Fracture Liaison Service ◽  
Reimbursement Mechanisms ◽  
Future Fracture ◽  
National Coalition ◽  
Fracture Liaison

SummaryIndividuals who have suffered fractures caused by osteoporosis – also known as fragility fractures – are the most readily identifiable group at high risk of suffering future fractures. Globally, the majority of these individuals do not receive the secondary preventive care that they need. The Fracture Liaison Service model (FLS) has been developed to ensure that fragility fracture patients are reliably identified, investigated for future fracture and falls risk, and initiated on treatment in accordance with national clinical guidelines. FLS have been successfully established in Asia, Europe, Latin America, North America and Oceania, and their widespread implementation is endorsed by leading national and international osteoporosis organisations. Multi-sector coalitions have expedited inclusion of FLS into national policy and reimbursement mechanisms. The largest national coalition, the National Bone Health Alliance (NBHA) in the United States, provides an exemplar of achieving participation and consensus across sectors. Initiatives developed by NBHA could serve to inform activities of new and emerging coalitions in other countries.

Thromboplastin Related Differences in the Determination of International Normalised Ratio: A Cause for Concern?

1994 ◽  
Vol 72 (03) ◽  
pp. 426-429 ◽  
Author(s):  
S Kitchen ◽  
I D Walker ◽  
T A L Woods ◽  
F E Preston
Keyword(s):  
Patient Management ◽  
External Quality Assessment ◽  
Oral Anticoagulant Therapy ◽  
Warfarin Dosage ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
International Normalised Ratio ◽  
The Uk ◽  
The Relationship

SummaryWhen the International Normalised Ratio (INR) is used for control of oral anticoagulant therapy the same result should be obtained irrespective of the laboratory reagent used. However, in the UK National External Quality Assessment Scheme (NEQAS) for Blood Coagulation INRs determined using different reagents have been significantly different.For 18 NEQAS samples Manchester Reagent (MR) was associated with significantly lower INRs than those obtained using Diagen Activated (DA, p = 0.0004) or Instrumentation Laboratory PT-Fib HS (IL, p = 0.0001). Mean INRs for this group were 3.15, 3.61, and 3.65 for MR, DA, and IL respectively. For 61 fresh samples from warfarin-ised patients with INRs of greater than 3.0 the relationship between thromboplastins in respect of INR was similar to that observed for NEQAS data. Thus INRs obtained with MR were significantly lower than with DA or IL (p <0.0001). Mean INRs for this group were 4.01, 4.40, and 4.59 for MR, DA, and IL respectively.We conclude that the differences between INRs measured with the thromboplastins studied here are sufficiently great to influence patient management through warfarin dosage schedules, particularly in the upper therapeutic range of INR. There is clearly a need to address the issues responsible for the observed discrepancies.

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