Fracture types affect clinical outcomes of patients managed within the fracture liaison and osteoporosis medication management services
Journal
Scientific reports
Journal Volume
9
Journal Issue
1
Date Issued
2019
Author(s)
Chang, Lo-Yu
Huang, Wei-Jia
Yang, Tsung-Han
Abstract
Osteoporosis medication in fragility fracture patients is associated with better outcomes. However, limited studies have investigated whether fracture types affect outcomes among patients undergoing treatment. We performed a secondary data analysis on participants from a fracture liaison service and an osteoporosis medication management service. Participants (n = 974) were regrouped into hip fracture (HF), vertebral fracture (VF), HF + VF, and NO HF/VF groups at baseline. Bivariate and multivariate logistic regressions were performed to identify baseline correlates on one-year mortality, incident refractures, and falls. Baseline characteristics were different among fracture groups. The HF group was oldest, with the lowest body mass index (BMI), lowest FRAX® T-score and had the highest 10-year fracture risk. After intervention, the HF group still had the highest mortality, but the HF + VF group had the highest refracture and incident fall rates. In the multivariate regression analysis, prevalent HF and VF, lower BMI and albumin level, and having chronic kidney disease or cancer were associated with higher mortality rates. HF + VF patients had the highest refracture risk. Prevalent HF and VF, older age and higher BMI, and having cancer or osteoarthritis were associated with a greater fall risk. HF and VF are associated with adverse outcomes, even under an optimal fracture care.
Other Subjects
bone density conservation agent; aged; aging; body mass; bone density; drug effect; falling; female; fragility fracture; hip fracture; human; male; malnutrition; mortality; osteoporosis; pathology; risk; risk factor; spine fracture; Accidental Falls; Aged; Aging; Body Mass Index; Bone Density; Bone Density Conservation Agents; Female; Hip Fractures; Humans; Male; Malnutrition; Osteoporosis; Osteoporotic Fractures; Risk; Risk Factors; Spinal Fractures
Publisher
NATURE PUBLISHING GROUP
Type
report