Access the full text.
Sign up today, get DeepDyve free for 14 days.
Loading next page...
/lp/springer-journals/three-year-outcomes-of-a-fracture-liaison-service-model-at-a-E60Cc4GFO4
- Publisher
- Springer Journals
- Copyright
- Copyright © The Author(s) 2023
- ISSN
- 1862-3522
- eISSN
- 1862-3514
- DOI
- 10.1007/s11657-023-01215-z
- Publisher site
- See Article on Publisher Site
Abstract
Summary Fragility hip fracture (FHF) is a serious complication of osteoporosis. A fracture liaison service (FLS) is crucial in preventing FHF. Our retrospective data of 489 patients with FHF and 3-year follow-ups demonstrated that the FLS improved functional outcomes. Our study’s mortality rates were lower than in other published series. Purpose This study assessed the 3-year outcomes after fragility hip fracture (FHF) treatment by a multidisciplinary team from the Siriraj Fracture Liaison Service (Si–FLS). The review investigated the administration rates of anti-osteoporosis medica- tion, refracture, and mortality; activities of daily living; mobility; and health-related quality of life. Methods A retrospective review was performed of the records of Si-FLS patients given FHF treatment between June 2016 and October 2018. The outcomes were evaluated at 3 time points: before discharge, and 1 and 3 years after treatment. Results The study enrolled 489 patients (average age, 78). The mortality and refracture rates at 1 year after hip fracture were 13.9% and 1.6%, respectively. At the 3-year follow-up, both rates were higher (20.4% and 5.7%, respectively). The Barthel Index and EuroQoL Visual Analogue Scale had risen to a plateau at the 1-year follow-up and remained stable to the 3-year follow-up. One year after treatment, approximately 60% of the patients could ambulate outdoors, and the proportion remained steady until the 3-year follow-up. There was no difference in the 1- and 3-year follow-up anti-osteoporosis medica- tion administration rates (approximately 40%). Conclusions This study confirms the benet fi s of having a multidisciplinary FLS care team to manage older people with FHF. An FLS improves the care of patients with FHF and the social support of caregivers and relatives. The FLS maintained the functional outcomes of the patients through 3 years of postfracture treatment. Keywords Anti-osteoporosis · Fracture liaison service (FLS) · Fragility hip fracture (FHF) · Functional outcomes · Mortality rate · Refracture rate Introduction Fragility hip fracture (FHF) is one of the most severe com- plications of osteoporosis [1]. Without appropriate treatment, there is a high risk of a subsequent fragility fracture, which Pojchong Chotiyarnwong and Nitchanant Kitcharanant contributed equally to this study. * Aasis Unnanuntana Department of Orthopaedics, Faculty of Medicine, Naresuan uaasis@gmail.com University, Phitsanulok, Thailand Department of Orthopedics, Bhumibol Adulyadej Hospital, Department of Orthopaedic Surgery, Faculty of Medicine Bangkok, Thailand Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Vol.:(0123456789) 1 3 26 Page 2 of 7 Archives of Osteoporosis (2023) 18:26 causes significant morbidity and mortality [2 ]. Although Siriraj Fracture Liaison Service assessment and treatment for osteoporosis are of prime importance in preventing secondary fracture, their adequate A multidisciplinary care team assessed all patients with provision is an issue worldwide [3]. In Asia, only one-third an FHF and treated them according to our center’s hip of patients with an FHF receive osteoporosis treatment [4]. fracture protocol [9]. After the treatment, video-based Concerted efforts to improve the diagnosis, treatment, osteoporosis education and supplementary reading mate- and prevention of FHFs are necessary to mitigate their rial were provided to the patients and their caregivers. ongoing strain on national economies and societies. Sev- A metabolic bone disease specialist team reviewed each eral programs have therefore been developed, such as the patient’s profile, and an appropriate anti-osteoporosis “Own the Bone” [5] and “Capture the Fracture” [6] initia- medication was suggested. Vitamin D2 supplementation tives. These aim to raise physicians’ awareness of FHF was prescribed according to patients’ baseline vitamin treatments, promote optimum treatment and care plans, D levels as previously described [10]. The dosage was and encourage long-term follow-up of patients with FHFs. 60,000 IU/week when patients’ baseline vitamin D levels The programs typically use a strategic secondary-fracture were below 20 ng/mL, 40,000 IU/week for levels between prevention model now commonly known as a fracture liai- 20 and 30 ng/mL, 20,000 IU/week for levels between 30 son service (FLS). The FLS is a cost-effective measure and 40 ng/mL, and zero for levels exceeding 40 ng/mL. that can reduce the rate of secondary fragility fractures, A fall-prevention protocol, including any necessary home increase the rate of osteoporosis treatment, and improve modifications, was developed by the multidisciplinary the quality of patient care [7]. care team. Once a patient was deemed fit for discharge, an Few studies on FLS have been conducted in Thailand. In FLS nurse coordinator transferred the postoperative care addition, some core clinical outcomes are underreported, plan to the treating physicians. Patients and caregivers such as postinjury mobility, performance in activities of were provided basic exercise and home physical therapy daily living, and quality of life after using an FLS [8]. There- information. fore, this study aimed to report the 3-year outcomes of the FLS at our institution using various outcome measures. They were mortality rate, the proportion of patients who sustained Assessment of outcomes a recurrent fracture, activities of daily living, and patients’ health-related quality of life. The results of this study reflect Demographic data and clinical information were collected the real-world effectiveness of an FLS model in a university- as follows: age, sex, body mass index, Charlson Comorbid- based tertiary care hospital setting. ity Index, the percentage of 10-year probability of frac- ture by the fracture risk assessment tool (FRAX) [11], history of fractures, preinjury ambulatory status, fracture site, and treatment type. Our outcomes of interest were Methods the following: Before this research began, the Institutional Review Board • mortality rate approved its protocol (COA no. Si 754/2019). We retrospec- • refracture rate (defined as any clinical osteoporotic tively reviewed patient data recorded in the Siriraj–FLS Reg- fracture) istry between July 2016 and October 2018. The investigation • the proportion of patients receiving calcium and vita- only assessed patients who had been diagnosed with femoral min D supplementation neck and intertrochanteric fractures and who had a minimum • the proportion of patients given anti-osteoporosis medi- follow-up of 1 year or until death. The exclusion criteria cations were as follows: In addition, we determined the bone mineral density Patients diagnosed with a pathological fracture confirmed (BMD) assessment rate during the first year after FHF by a pathological study. These patients were excluded treatment. We also collected details of functional outcome since their prognoses differ from those of patients with measures as follows: an osteoporotic fracture. Patients who sustained multiple injuries or fractures. This • activities of daily living (using the Barthel Index) group of patients was excluded because their rehabilita- • health-related quality of life (using the EuroQoL–Vis- tion programs and recovery are different from those of ual Analogue Scale) patients sustaining a hip fracture only. • postfracture ambulatory status 1 3 Archives of Osteoporosis (2023) 18:26 Page 3 of 7 26 Patients’ postfracture ambulatory statuses were classi- Equal proportions of patients were diagnosed with femo- fied as bedridden, indoor ambulator, and outdoor ambula- ral neck and intertrochanteric femoral fractures. Most tor. All outcome measures were evaluated at 3 time points: patients received surgical treatment for FHF. Nearly 60% before discharge, and 1 and 3 years after treatment. The of the patients were outdoor ambulators before their injury postdischarge evaluations were conducted by telephone (Table 1). interviews with the patients or, if they could not commu- During the 3-year follow-up, the cumulative deaths nicate via telephone, their primary caregivers. were 13, 68, and 100 at discharge and 1 and 3 years after hip fracture treatment, respectively. Thus, the in-hospital Barthel Index mortality rate of our patient population was 2.7%; the rate rose to 13.9% and 20.4% at 1 and 3 years after hip fracture The Barthel Index (BI) is a 10-item ordinal scale used to treatment, respectively. During the data collection period, evaluate patients’ functional independence in performing excluding deaths, none of our patients was lost to follow- their activities of daily living. Mahoney and Barthel DW up. Therefore, the total numbers of patients available for introduced the BI in 1965 [12]. It has a total possible score statistical analysis were 476, 421, and 389 at discharge and of 100, with higher scores indicating high degrees of mobil- the 1- and 3-year follow-ups, respectively (Fig. 1). ity in the activities of daily living. A Thai-language version During hospitalization, all patients and their caregivers of the scoring system has been validated for use with older received video-based osteoporosis educational material. patients with FHFs [13]. BMD assessments were carried out on 397 patients (81.2%) 1 year after their FHFs. The proportion of patients who EuroQoLV ‑ isual Analogue Scale received calcium and vitamin D supplementation was 98.3% at discharge, and this proportion remained at approximately The EuroQoL-Visual Analogue Scale (EQ-VAS) records a 90% during the 3-year follow-up. Regarding anti-osteopo- patient’s self-rated health status on a vertical 20-cm visual rosis medications, the rate of prescribing anti-osteoporosis analog scale. Its grading ranges from “0” (the worst possible medication before discharge was only 13.4%. At the 1- and health status that you can imagine) to “100” (the best pos- 3-year follow-ups, the proportion of patients using anti- sible health status that you can imagine). Patients mark an osteoporosis medication had risen to approximately 40% “X” on the scale in the position that reflects their perception (Table 2). Oral bisphosphonates were the most commonly of their current health status. This tool has been validated in prescribed anti-osteoporosis agents. Interestingly, of those older adults with FHFs [9, 14]. Statistical analysis Table 1 Patient demographic and clinical characteristics Characteristics Hip fracture Descriptive statistics were used. Continuous variables are patients presented as the means, standard deviations, and ranges, (N = 489) while categorical variables are summarized as frequencies Female sex 352 (72.0%) and percentages. Changes in BI and EQ-VAS scores from Age (years) 78.4 ± 9.8 discharge to 1 and 3 years after a hip fracture were assessed Body mass index (kg/m ) 22.3 ± 3.9 with a one-way repeated-measure analysis of variance Charlson Comorbidity Index (one-way repeated ANOVA). The BI and EQ-VAS scores at < 3 36 (7.3%) discharge and the 1- and 3-year follow-ups were compared ≥ 3 453 (92.6%) using post hoc analysis with Bonferroni correction. Data History of previous fracture 15 (3.1%) analyses were performed using PASW Statistics for Win- Preinjury ambulatory status dows, version 18 (SPSS Inc., Chicago, IL, USA). Probability Bedridden 15 (3.1%) (P) values ≤ 0.05 were considered statistically significant. Indoor ambulator 188 (38.5%) Outdoor ambulator 286 (58.5%) Site of fracture Results Femoral neck 248 (50.7%) Intertrochanter 241 (49.3%) From July 2016 to October 2018, data on 489 patients with Type of hip fracture treatment FHFs were entered into the Siriraj–FLS Registry. Their Conservative 32 (6.5%) average age was 78.4 years, and most were female (72%). Fixation 254 (52.0%) The average body mass index was approximately 22.3 kg/ Arthroplasty 203 (41.5%) m , and over 90% had a Charlson Comorbidity Index ≥ 3. 1 3 26 Page 4 of 7 Archives of Osteoporosis (2023) 18:26 13.2 ± 6.8%, while the 10-year probability of a hip fracture was 6.8 ± 5.2%. Regarding the functional outcomes and quality of life of the patients, the mean and standard deviation of the BI score at discharge was 42.1 ± 25.0. This score increased significantly, reaching 80.6 ± 26.6 at the 1-year follow-up (P < 0.001) and remained stable (P = 1.000) until the 3-year follow-up (80.6 ± 25.7; Fig. 2A). Similarly, the mean base- line EQ-VAS score at discharge (52.7 ± 23.1) improved sig- nificantly to a plateau of 77.0 ± 17.5 at the 1-year follow- up. The score then remained steady to the 3-year follow-up assessment (77.4 ± 16.6; Fig. 2B). Discussion With the populations in many countries around the world aging rapidly, higher incidences of fragility fractures are inevitable. These fractures are associated with increased disability, morbidity, and mortality. If these problems are not satisfactorily addressed, the rise in fragility fractures will adversely impact patients’ health and place substantial economic burdens on societies [15–18]. Our outcomes sup- port that an FLS can be beneficially used to care for patients with fragility fractures. As at September 2022, 17 FLSs in Thailand were included in the “Map of Best Practice” main- tained by the International Osteoporosis Foundation (https:// www. captu rethe fract ure. org/ map- of- best- pract ice). Compared with other reports from the Asia–Pacific region [8], a substantial proportion of the patients in our study cohort (81.2%) underwent BMD assessment 1 year after their hip fractures. This rate of BMD testing was much higher than the median rate reported by a systematic review Fig. 1 The flow of patients managed by the Siriraj–FLS from their and meta-analysis (81.2% vs 48%) [19]. Of the patients who admission through their 3-year follow-up, between July 2016 and underwent BMD assessments, the proportion who received October 2018 anti-osteoporosis medications was significantly higher than the proportion who did not (87% vs 13%). In 2019, who received anti-osteoporosis medication within 1 year Kittithamvongs and Pongpirul reported that BMD results after their hip fracture, only 13% had not received BMD influence physicians’ decisions regarding the prescription of testing, while 87% had DXA results (P < 0.001). anti-osteoporosis medications to patients with osteoporotic Regarding postfracture ambulatory status, the proportions hip fractures [20]. Additionally, in a country neighboring of bedridden patients were 9.9%, 11.2%, and 8.7% at dis- Thailand, inaccessibility to BMD testing was found to be charge and at the 1- and 3-year follow-ups, respectively. The a barrier to osteoporosis management [21]. Therefore, our rate of patients who could ambulate outdoors at discharge results suggest that increasing the BMD assessment rate was only 13.7%. However, the proportion rose substantially could raise awareness of the need for anti-osteoporosis medi- to approximately 65% and 58% at the 1- and 3-year follow- cation prescriptions. ups, respectively (Table 2). Eight patients (1.6%) sustained In addition, the refracture rate of our Siriraj-FLS patients a secondary fracture within 1 year of their hip fracture (5.7% at the 3-year follow-up) was considered low and com- treatment. At the minimum follow-up of 3 years, the rate of parable to those reported in a systematic review (0–6.5%) [8] subsequent fractures was 5.7%. The 3 most common sites and a meta-analysis (6.4%) [19]. Drawing upon the 10-year of recurrent fractures were the contralateral hip (3.9%), the fracture probabilities calculated by FRAX, our 10-year distal femur (0.6%), and the distal radius (0.4%). The aver- probabilities of major osteoporotic and hip fractures were age 10-year probability of a major osteoporotic fracture was 13.2 ± 6.8% and 6.8 ± 5.2%, respectively. The observed 1 3 Archives of Osteoporosis (2023) 18:26 Page 5 of 7 26 Table 2 Key indices of patients Key performance indices Discharge (n = 476) 1-year 3-year at discharge and at the 1- and post-fracture post-fracture 3-year follow-ups (n = 421) (n = 389) Rate of BMD assessment* 397 (81.2%) Rate of calcium and vitamin D supplementation 468 (98.3%) 391 (92.8%) 352 (90.5%) Rate of treatment with anti-osteoporosis medication 64 (13.4%) 171 (40.6%) 153 (39.3%) Oral bisphosphonate 37 (7.8%) 114 (27.1%) 98 (25.2%) Intravenous bisphosphonate 7 (1.5%) 10 (2.4%) 6 (1.5%) Denosumab 13 (2.7%) 42 (10.0%) 44 (11.3%) Teriparatide 5 (1.1%) 4 (1.0%) 5 (1.3%) Strontium ranelate** 2 (0.4%) 1 (0.2%) 0 (0%) Post-fracture ambulatory status Bedridden 47 (9.9%) 47 (11.2%) 34 (8.7%) Indoor ambulator 364 (76.5%) 101 (24.0%) 129 (33.2%) Outdoor ambulator 65 (13.7%) 273 (64.8%) 226 (58.1%) Rate of refracture* 0 (0.0%) 8 (1.6%) 28 (5.7%) The rates were calculated based on the total of 489 FHF patients enrolled in this study ** Strontium ranelate has not been available since 2017 Fig. 2 Overall mean Barthel Index (A) and EQ-VAS (B) scores at discharge, and at the 1-year and 3-year follow-ups, of the patients with fragility hip fracture managed by the Siriraj-FLS percentage of (new) fractures after 3 years of the index hip both EQ-VAS and BI). Our mean post-hip fracture BI and fracture was still under the estimated percentage of fractures EQ-VAS scores are comparable to the scores reported by at 10 years. It would be interesting to monitor these patients previous studies. For instance, Chiang et al. [22] and Imai over an extended follow-up period to assess the validity of et al. [23] reported mean BI scores of 71.1 and 71.9 points the FRAX for Thais. at 1- and 2-year post-hip fracture treatment, respectively. Our low refracture rate might result from several factors. Similarly, our mean 1-year EQ-VAS score (77.0 ± 17.5) is One is our comprehensive fall prevention program, which is comparable to the mean of 67 ± 2 reported by Svedbom et al. part of the osteoporosis education given to all patients and [24] and the mean of 80 ± 10 found by van der Vet et al. [25] their caregivers. The other factor is the high rate of BMD Our 1- and 3-year mortality rates were 13.9% and 20.4%, testing, which facilitates the prevention of secondary fragil- respectively. These numbers were compatible with those ity fractures by identifying patients at risk and encouraging reported in a previous systematic review and meta-analysis their compliance with anti-osteoporosis therapy. It is also of various centers with an FLS care model [8, 19]. In con- important to note that over 90% of our patients received trast, Vaseenon et al. reported a much higher mortality rate calcium and vitamin D supplementation. As for those who in Thai patients with FHF who were not under the care of did not receive supplementation, most had serum calcium an FLS program. Those patients had 1- and 3-year mortal- and vitamin D levels within the normal ranges. ity rates of 18% and 32%, respectively [26]. The lower rates The mean 1-year BI and EQ-VAS scores increased dra- for patients under FLS management probably stem from matically from their baseline values. Afterwards, there the multidisciplinary team approach with a dedicated nurse were no statistically significant differences between our BI coordinator. Having a dedicated nurse coordinator appears and EQ-VAS scores at the 1-year follow-up and their cor- to be one of the keys to the success of an FLS [27, 28]. responding values at the 3-year follow-up (P = 1.000 for Therefore, these findings underscore the effectiveness of an 1 3 26 Page 6 of 7 Archives of Osteoporosis (2023) 18:26 Fracture Liaison Service for providing data for this study. We are also FLS care model to improve the quality of hip fracture care indebted to Mr David Park for English-language editing. and reduce mortality in this patient population. Interestingly, in 2005, only 4% of patients in Thailand Author contribution PC and NK: writing–original draft. AU: writing– received anti-osteoporosis medications after hip fracture in review and editing, and supervision. All authors: design/conception, data collection and analysis, conclusions, suggestions, and review of centers without an FLS [29]. Our anti-osteoporosis treat- paper. All authors also read and approved the final version of the manu- ment rate after FHF was approximately 40%. This rate was script submitted for publication. comparable to the unweighted average of 38% found by the meta-analysis [19]. Factors associated with not receiving Data Availability The data used in this study are available from the corresponding author upon reasonable request. anti-osteoporosis medication are multifactorial. Among them are healthcare-cost reimbursement schemes (given that Declarations oral bisphosphonate was the only anti-osteoporosis agent whose costs were fully covered for all osteoporosis patients Ethics approval The protocol and consent forms used in this study in Thailand), healthcare systems, patients and caregivers’ were approved by the Siriraj Institutional Review Board of the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand perceptions of osteoporosis treatment, and physicians and (COA no. Si 754/2019). policy makers’ beliefs about the benefits of secondary frac- ture prevention. Therefore, further study is required to delin- Conflicts of interest None. eate the reasons for not-receiving anti-osteoporosis medica- tion. We acknowledge that there is room for improvement in Open Access This article is licensed under a Creative Commons Attri- our anti-osteoporosis treatment rate and that new interven- bution 4.0 International License, which permits use, sharing, adapta- tion, distribution and reproduction in any medium or format, as long tions should be employed to improve the initiation of and as you give appropriate credit to the original author(s) and the source, adherence to anti-osteoporosis medications. provide a link to the Creative Commons licence, and indicate if changes The strength of this study is that our FLS collected data were made. The images or other third party material in this article are related to a range of core outcomes. They were pre- and included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in postinjury ambulation, performance in activities of daily liv- the article's Creative Commons licence and your intended use is not ing, and quality of life after FLS implementation. These out- permitted by statutory regulation or exceeds the permitted use, you will comes have tended to be underreported in the literature, yet need to obtain permission directly from the copyright holder. To view a they are crucial to determining the comprehensive status of copy of this licence, visit http://cr eativ ecommons. or g/licen ses/ b y/4.0/ . patients with FHFs. Nonetheless, there are some limitations to this study. First, our study had a retrospective design; nevertheless, the fact that we collected data from our FLS References registry minimized potential biases. Second, this study drew upon data from only one center in Thailand, a high-volume 1. Chapurlat RD, Bauer DC, Nevitt M, Stone K, Cummings SR hospital with an experienced FLS team. Consequently, some (2003) Incidence and risk factors for a second hip fracture in elderly women. The Study of Osteoporotic Fractures. Osteoporos aspects of our data and findings may not be generalizable to Int 14:130–136. https:// doi. org/ 10. 1007/ s00198- 002- 1327-6 centers that provide a less sophisticated level of care or do 2. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA not have an FLS. (1999) Mortality after all major types of osteoporotic fracture in In conclusion, our findings concur with previous reports men and women: an observational study. Lancet 353:878–882. https:// doi. org/ 10. 1016/ S0140- 6736(98) 09075-8 that FLSs contribute to significant improvements in the 3. Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR, rates of osteoporosis education and calcium and vitamin Eisman JA, March L, Seibel MJ (2013) Models of care for the sec- D supplementation, with resulting satisfactory functional ondary prevention of osteoporotic fractures: a systematic review outcomes and excellent BMD and refracture rates. Because and meta-analysis. Osteoporos Int 24:393–406. https://doi. or g/10. 1007/ s00198- 012- 2090-y FLSs are highly beneficial to patients with fragility fractures, 4. Kung AW, Fan T, Xu L et al (2013) Factors influencing diag- they should be established at all centers. Nevertheless, only nosis and treatment of osteoporosis after a fragility fracture approximately 40% of our patients with FHFs adhered to among postmenopausal women in Asian countries: a retrospec- their anti-osteoporosis treatment. Further study is needed tive study. BMC Womens Health 13:7. https:// doi. org/ 10. 1186/ 1472- 6874- 13-7 to identify the reasons for unsatisfactory anti-osteoporosis 5. Tosi LL, Gliklich R, Kannan K, Koval KJ (2008) The American compliance, and specific interventions should be explored Orthopaedic Association’s “own the bone” initiative to prevent to increase the rate of anti-osteoporosis initiation. secondary fractures. J Bone Joint Surg Am 90:163–173. https:// doi. org/ 10. 2106/ JBJS.G. 00682 Acknowledgements The authors thank Ms Wachirapan Narktang and 6. Akesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Ms Kornkanok Sangwiroon of the Division of Research, Department Pierroz DD, Kyer C, Cooper C, Group IOFFW (2013) Capture of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol the fracture: a best practice framework and global campaign to University, Bangkok, Thailand, for assisting with data collection and break the fragility fracture cycle. Osteoporos Int 24:2135–2152. statistical analysis. We gratefully acknowledge the staff of the Siriraj https:// doi. org/ 10. 1007/ s00198- 013- 2348-z 1 3 Archives of Osteoporosis (2023) 18:26 Page 7 of 7 26 7. Siris ES, Bilezikian JP, Rubin MR, Black DM, Bockman RS, Bone 19. Wu CH, Tu ST, Chang YF, Chan DC, Chien JT, Lin CH, Singh HG, Hochberg MC, McClung MR, Schnitzer TJ (2003) Pins and S, Dasari M, Chen JF, Tsai KS (2018) Fracture liaison services plaster aren’t enough: a call for the evaluation and treatment of improve outcomes of patients with osteoporosis-related fractures: patients with osteoporotic fractures. J Clin Endocrinol Metab a systematic literature review and meta-analysis. Bone 111:92– 88:3482–3486. https:// doi. org/ 10. 1210/ jc. 2003- 030568 100. https:// doi. org/ 10. 1016/j. bone. 2018. 03. 018 8. Chang Y, Huang C, Hwang J, Kuo J, Lin K, Huang H, Bagga 20. Kittithamvongs P, Pongpirul K (2019) Prescription practices of S, Kumar A, Chen F, Wu C (2018) Fracture liaison services for anti-osteoporosis medication among Thai orthopedic surgeons osteoporosis in the Asia-Pacific region: current unmet needs and (PAMOS study) in osteoporotic hip fracture. Arch Osteoporos systematic literature review. Osteoporos Int 29:779–792. https:// 14:62. https:// doi. org/ 10. 1007/ s11657- 019- 0616-z doi. org/ 10. 1007/ s00198- 017- 4347-y 21. Tay CL, Ng WL, Beh HC, Lim WC, Hussin N (2022) Screening 9. Anusitviwat C, Vanitcharoenkul E, Chotiyarnwong P, Unnanun- and management of osteoporosis: a survey of knowledge, attitude tana A (2022) Surgical treatment for fragility hip fractures during and practice among primary care physicians in Malaysia. Arch the COVID-19 pandemic resulted in lower short-term postopera- Osteoporos 17:72. https:// doi. org/ 10. 1007/ s11657- 022- 01111-y tive functional outcome and a higher complication rate compared 22. Chiang MH, Huang YY, Kuo YJ, Huang SW, Jang YC, Chu to the pre-pandemic period. Osteoporos Int. https:// doi. org/ 10. FL,Chen YP (2022) Prognostic factors for mortality, activity of 1007/ s00198- 022- 06485-w daily living, and quality of life in Taiwanese older patients within 10. Unnanuntana A, Chotiyarnwong P (2017) The use of strati- 1 year following hip fracture surgery. J Pers Med 12:102. https:// fied vitamin D2 supplementation regimen for restoring and doi. org/ 10. 3390/ jpm12 010102 maintaining sufficient vitamin D level. J Med Assoc Thailand 23. Imai N, Endo N, Suda K, Suzuki H (2021) Multidisciplinary 100:1095–1103 approach to reduce postoperative complications and improve the 11. Kanis JA, Oden A, Johansson H, Borgstrom F, Strom O, McClos- activity of patients with hip fracture: a 24-month follow-up survey. key E (2009) FRAX and its applications to clinical practice. Bone Acta Med Okayama 75:595–600. https://doi. or g/10. 18926/ AMO/ 44:734–743. https:// doi. org/ 10. 1016/j. bone. 2009. 01. 373 62772 12. Mahoney FI, Barthel DW (1965) Functional evaluation: the Bar- 24. Svedbom A, Borgstrom F, Hernlund E et al (2018) Quality of life thel index. Md State Med J 14:61–65 after hip, vertebral, and distal forearm fragility fractures measured 13. Unnanuntana A, Jarusriwanna A, Nepal S (2018) Validity using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from and responsiveness of Barthel index for measuring functional the ICUROS. Qual Life Res 27:707–716. https://doi. or g/10. 1007/ recovery after hemiarthroplasty for femoral neck fracture. Arch s11136- 017- 1748-5 Orthop Trauma Surg 138:1671–1677. https:// doi. org/ 10. 1007/ 25. van der Vet PCR, Kusen JQ, Rohner-Spengler M, Link BC, s00402- 018- 3020-z Verleisdonk EMM, Knobe M, Henzen C, Schmid L, Babst 14. Tidermark J, Zethraeus N, Svensson O, Tornkvist H, Ponzer S R, Beeres FJP (2021) The quality of life, patient satisfaction (2002) Quality of life related to fracture displacement among and rehabilitation in patients with a low energy fracture-part elderly patients with femoral neck fractures treated with inter- III of an observational study. Geriatr Orthop Surg Rehabil nal fixation. J Orthop Trauma 16:34–38. https:// doi. org/ 10. 1097/ 12:21514593211046410. https:// doi. or g/ 10. 1177/ 21514 59321 00005 131- 20020 1000- 0000810464 07 15. Chandran M, Lau TC, Gagnon-Arpin I, Dobrescu A, Li W, 26. Vaseenon T, Luevitoonvechkij S, Wongtriratanachai P, Roja- Leung MYM, Patil N, Zhao Z (2019) The health and economic nasthien S (2010) Long-term mortality after osteoporotic hip frac- burden of osteoporotic fractures in Singapore and the potential ture in Chiang Mai, Thailand. J Clin Densitom 13:63–67. https:// impact of increasing treatment rates through more pharmacologi-doi. org/ 10. 1016/j. jocd. 2009. 10. 003 cal options. Arch Osteoporos 14:114. https:// doi. org/ 10. 1007/ 27. Huang CM, Su CY, Chien LY, Guo JL (2011) The effectiveness s11657- 019- 0664-4 of an osteoporosis prevention program among women in Taiwan. 16. Lau EM, Lee JK, Suriwongpaisal P, Saw SM, De Das S, Khir A, Appl Nurs Res 24:e29-37. https://doi. or g/10. 1016/j. apnr .2010. 02. Sambrook P (2001) The incidence of hip fracture in four Asian 006 countries: the Asian Osteoporosis Study (AOS). Osteoporos Int 28. Inderjeeth CA, Glennon DA, Poland KE, Ingram KV, Prince 12:239–243. https:// doi. org/ 10. 1007/ s0019 80170 135 RL, Van VR, Holman CD (2010) A multimodal intervention to 17. Marsh D, Akesson K, Beaton DE et al (2011) Coordinator- improve fragility fracture management in patients presenting to based systems for secondary prevention in fragility fracture emergency departments. Med J Aust 193:149–153. https://doi .o rg/ patients. Osteoporos Int 22:2051–2065. https:// doi. org/ 10. 1007/ 10. 5694/j. 1326- 5377. 2010. tb039 58.x s00198- 011- 1642-x 29. Rojanasthien S, Chiewchantanakit S, Vaseenon T (2005) Diagno- 18. Kanis JA on behalf of the World Health Organization Scientific sis and treatment of osteoporosis following hip fracture in Chiang Group (2007) Assessment of osteoporosis at the primary health- Mai University Hospital. J Med Assoc Thai 88(Suppl 5):S65-71 care level. Technical Report. WHO Collaborating Centre, Univer- sity of Sheffield, UK. Available at https:// www . she ffi eld. ac. uk/ Publisher's note Springer Nature remains neutral with regard to FRAX/pdf s/WHO_ T echnical_ R eport.pdf . Accessed 19 April 2022 jurisdictional claims in published maps and institutional affiliations. 1 3
Journal
Archives of Osteoporosis – Springer Journals
Published: Jan 24, 2023
Keywords: Anti-osteoporosis; Fracture liaison service (FLS); Fragility hip fracture (FHF); Functional outcomes; Mortality rate; Refracture rate