scholarly journals Secondary prevention of fragility fractures: instrumental role of a fracture liaison service to tackle the risk of imminent fracture

2019 ◽  
pp. 235-242 ◽  
Author(s):  
Ronald MY Wong ◽  
◽  
SW Law ◽  
KB Lee ◽  
Simon KH Chow ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Fragility Fractures ◽  
Fracture Liaison Service ◽  
Fracture Liaison ◽  
Instrumental Role

scholarly journals Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland

2021 ◽  
Author(s):  
P. Lüthje ◽  
I. Nurmi-Lüthje ◽  
N. Tavast ◽  
A. Villikka ◽  
M. Kataja
Keyword(s):  
Secondary Prevention ◽  
Excess Mortality ◽  
Assessment Tool ◽  
Fragility Fractures ◽  
Fracture Prevention ◽  
Fracture Liaison Service ◽  
Low Energy ◽  
Secondary Fracture ◽  
Dxa Scans ◽  
Fracture Liaison

Abstract Background Fracture liaison service (FLS) is a secondary prevention model for identification of patients at risk for fragility fractures. Aims This study was conducted to evaluate the number and costs of secondary prevention of low-energy fractures in the city of Kouvola in Finland. Methods Women aged ≥ 45 years and men ≥ 60 years treated in the emergency department with a low-energy fracture were identified. Laboratory testing, BMI, and DXA scans were performed. Fracture Risk Assessment Tool was used. The direct FLS costs were calculated. Survival was analyzed using univariate and multivariate analysis and the life-table method. Results 525 patients with 570 fractures were identified. The mean age of women was 73.8 years and of men 75.9 years. Most patients sustained wrist (31%), hip (21%) or proximal humerus (12%) fractures. 41.5% of the patients had osteoporosis according to DXA scans. 62% of patients used calcium and vitamin D daily and 38% started anti-osteoporotic medication. Protective factors for survival were: age < 80 years, female sex, and S-25OHD concentration of 50–119 nmol/L. Excess mortality was highest among patients with a fracture of the femur. The total annual direct costs of FLS were 1.3% of the costs of all fractures. Discussion Many low-energy fracture types were associated with excess mortality. The use of anti-osteoporotic medication was not optimal. Conclusions FLS increased the catchment of low-energy fracture patients and was inexpensive. However, identification, evaluation and post-fracture assessment of patients should be expedited. Rehabilitation of hip fracture patients needs to be improved.

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.

Fragility Vertebral Compression Fractures in Postmenopausal Women: The Role of a Fracture Liaison Service Program

2020 ◽  
pp. 000313482093325
Author(s):  
Avery Jackson ◽  
Tarik Wasfie ◽  
Caramarie Brock ◽  
Stefanija Galovska ◽  
Melany Smalley ◽  
...  
Keyword(s):  
Vitamin D ◽  
Postmenopausal Women ◽  
Fragility Fractures ◽  
Fracture Liaison Service ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Vitamin D Levels ◽  
Group A ◽  
Group B ◽  
Fracture Liaison

Background As the aging population increases in the United States, so has the prevalence of osteoporosis (10.2 million adults aged 50 years and older in 2010). Programs to manage the increased incidence of fragility fractures in such patients particularly the postmenopausal women are the priority. Programs such as the Fracture Liaison Service (FLS) might be the answer. Methods Data of 256 postmenopausal women with vertebral compression fractures treated with vertebroplasty between 2012 and 2017 were divided into 2 groups. Group A were patients seen between 2012 and 2014 before the establishment of the FLS program at the clinic. Group B were patients seen between 2015 and 2017 who presented to the FLS program in our clinic. Data collected included demographics, refracture rates, dual-energy X-ray absorptiometry (DEXA) scan T-scores, fracture risk score (FRAX), serum calcium and vitamin D levels, and comorbid conditions. Results There were 103 female patients with a mean age of 79.75 years (standard deviation [SD] ± 10.86) in group A, while group B had 153 patients with a mean age of 75.66 years (SD ± 10.78). There was no significant difference in the DEXA scan T-scores, FRAX scores, and mean serum calcium and vitamin D levels; however, there was a significant reduction in the refracture rate for vertebral compression fractures ( P = .003). Conclusion FLS programs, when implemented, will have a beneficial effect in reducing refracture rates of postmenopausal women with osteoporotic fragility fractures.

scholarly journals Diagnosis and therapy of osteoporosis in geriatric trauma patients: an update

2016 ◽  
Vol 1 (2) ◽  
pp. 65-71 ◽  
Author(s):  
Deborah Schray ◽  
Ulla Stumpf ◽  
Christian Kammerlander ◽  
Wolfgang Böcker ◽  
Carl Neuerburg
Keyword(s):  
Secondary Prevention ◽  
Medical Condition ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Fracture Liaison Service ◽  
Subsequent Treatment ◽  
Geriatric Trauma ◽  
Hospital Treatment ◽  
Trauma Patients ◽  
Osteoporosis Therapy

AbstractDemographic changes confront clinicians with an increasing number of orthogeriatric patients. These patients present with comorbidities, which force their surgeons to take into consideration their medical condition. A major risk factor for fractures in orthogeriatric patients is osteoporosis in combination with frailty. To prevent subsequent fractures in these patients, we need to pay attention to adequate osteoporosis treatment in orthogeriatric patients. There is a huge treatment gap. In Germany, 77% of patients with osteoporosis are not treated adequately. Even after fragility fractures, a low percentage of patients receive a specific osteoporosis therapy. Secondary prevention is of great importance in the treatment of these patients. Diagnostics and treatment should be already initiated with the admission to the hospital. Treatment decisions need to be made individually based on the risk profile of the patients. After discharge, it is important to involve the patients’ general practitioners and to follow up on patients regularly to improve their compliance and to ensure adequate therapy. Establishing a fracture liaison service helps coordinating osteoporosis treatment during hospitalization and after discharge. Subsequent fractures can be reduced; therefore, it is an effective service for secondary prevention. The present article provides an overview of how an efficient identification and subsequent treatment of osteoporosis can be achieved in aged trauma patients.

Does a Fracture Liaison Service Program Minimize Recurrent Fragility Fractures in the Elderly With Osteoporotic Vertebral Compression Fractures?

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tarik Wasfie ◽  
Avery M Jackson
Keyword(s):  
Retrospective Chart Review ◽  
Fragility Fractures ◽  
The United States ◽  
Fracture Liaison Service ◽  
Vertebral Compression Fractures ◽  
P Value ◽  
Compression Fractures ◽  
Group A ◽  
Group B ◽  
Fracture Liaison

Abstract INTRODUCTION There is a sizable proportion of elderly, both men and women, with fragility fractures, approximately 2 million fractures per year in the United States. METHODS A retrospective chart review of 365 patient presented between January 2012 and December 2017 with vertebral compression fractures. Prepost study design to determine refracture between group A (before Fracture Liaison Service (FLS)) and group B, after calcium, vitamin D, DEXA scans, FRAX scores, and refracture rates were measured. RESULTS Mean age for group A and B were 79.0 and 74.9 yr, respectively, and predominantly females. Serum calcium was higher in group B (9.51 mg/DL) but not significan (P = .19). Fracture score among the groups was similar (20% vs 22%; P = .44). The total refracture rate for both vertebral and other fracture was significantly less in the post FLS patients, 36.5% vs 56% P-value = .01. CONCLUSION FLS program benefited patients with fragility fractures by decreasing the incidence of all refracture rates.

scholarly journals The impact of a standardized order set for the management of non-hip fragility fractures in a Fracture Liaison Service

2016 ◽  
Vol 27 (12) ◽  
pp. 3439-3447 ◽  
Author(s):  
A. Senay ◽  
J. Delisle ◽  
M. Giroux ◽  
G. Y. Laflamme ◽  
S. Leduc ◽  
...  
Keyword(s):  
Fragility Fractures ◽  
Fracture Liaison Service ◽  
The Impact ◽  
Fracture Liaison ◽  
Order Set
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