Fragility Fracture Prevention Treatment in a Continued Care Facility: An Opportunity for Intervention

Auteurs

  • André Pinto Saraiva Serviço de Medicina Física e de Reabilitação Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Sofia Sousa Moreira Centro de Medicina de Reabilitação da Região Centro Rovisco Pais, Tocha, Portugal
  • Carolina Paiva Centro de Medicina de Reabilitação da Região Centro Rovisco Pais, Tocha, Portugal
  • Pedro Alves Peixoto Departamento de Psiquiatria e Saúde Mental - Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
  • Jorge Laíns Serviço de Medicina Física e de Reabilitação Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

DOI :

https://doi.org/10.25759/spmfr.484

Mots-clés :

osteoporosis, frail elderly, bone fractures, rehabilitation, patient care

Résumé

Introduction: Fragility fractures occur spontaneously or after minor trauma. They are common in frail patients and are associated with increased disability, morbidity and mortality. Fragility fractures account for a considerable number of admissions in continued care facilities, representing a major economic burden. Our aim was to evaluate whether patients admitted to a continued care facility with a fragility fracture diagnosis have received adequate treatment to prevent new fractures.
Methods: This is a retrospective cohort study conducted at Unidade de Cuidados Continuados de Convalescença Rovisco Pais. All patients admitted from July 2021 to August 2022 with a fragility fracture were included.
Results: Eighty eight patients were included (mean age 85±8.71 years; female 76.2%; average length of stay 60±25.8 days; proximal femur fracture 91.3%, vertebral fractures 8.8%). At the time of discharge, 16 (2.6%) had been prescribed antiresorptive drugs; 15 (20.5%) received vitamin D and only 2 (2.7%) had been prescribed calcium. Six (7.5%) had a subsequent fracture. Frail patients were older, had more falls and were more likely to have an adverse event during stay.
Conclusion: Although all patients had indication for treatment with antiresorptive drugs, and despite the availability of effective pharmacologic interventions and well- established guidelines for fracture prevention, only a minority received such treatment. These findings support that there is clear room for improvement and this study sets the pace for developing an intervention protocol.

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Références

Li N, Hiligsmann M, Boonen A, van Oostwaard MM, de Bot RTAL, Wyers CE, et al. The impact of fracture liaison services on subsequent fractures and mortality: a systematic literature review and meta-analysis. Osteoporos Int. 2021;32:1517-30. doi: 10.1007/s00198-021-05911-9.

Migliorini F, Giorgino R, Hildebrand F, Spiezia F, Peretti GM, Alessandri-Bonetti M, et al. Fragility Fractures: Risk Factors and Management in the Elderly. Medicina. 2021;57:1119. doi: 10.3390/medicina57101119.

Song Y, Wu Z, Huo H, Zhao P. The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis. Front Public Health. 2022;10:890652. doi: 10.3389/fpubh.2022.890652.

Hoffmann S, Wiben A, Kruse M, Jacobsen KK, Lembeck MA, Holm EA. Predictive validity of PRISMA-7 as a screening instrument for frailty in a hospital setting. BMJ Open. 2020;10:e038768. doi: 10.1136/bmjopen-2020-038768.

Marques A, Rodrigues AM, Romeu JC, Ruano A, Barbosa AP, Águas F, et al. Recomendações multidisciplinares portuguesas sobre o pedido de DXA e indicação de tratamento de prevenção das fraturas de fragilidade. Rev Port Clíni Geral. 2016;32:425-41. doi:10.32385/rpmgf.v32i6.11964

Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, et al. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. Acta Reumatol Port. 2018;43:10-31.

Harvey NC, D'Angelo S, Paccou J, Curtis EM, Edwards M, Raisi-Estabragh Z, et al. Calcium and Vitamin D Supplementation Are Not Associated With Risk of Incident Ischemic Cardiac Events or Death: Findings From the UK Biobank Cohort. J Bone Miner Res. 2018;33:803-11.

Magnuszewski L, Wojszel A, Kasiukiewicz A, Wojszel ZB. Falls at the Geriatric Hospital Ward in the Context of Risk Factors of Falling Detected in a Comprehensive Geriatric Assessment. Int J Environ Res Public Health. 2022;19:10789. doi: 10.3390/ijerph191710789.

Mai H, Mc Evoy L, Wilson C, Marov L, Kelly A, Haddad CE, Chroinin DN, Hassett G, Frost SA. Frailty and risk of subsequent fracture among older adults presenting to hospital with a minimal trauma fracture. Osteoporos Int. 2023;34:399-404. doi: 10.1007/s00198-022-06630-5.

Feng LR, Lilienthal M, Galet C, Skeete DA. Frailty as a predictor of negative outcomes in trauma patients with rib fractures. Surgery. 2023;173:812-20. doi: 10.1016/j.surg.2022.07.046.

Won BL, Chan YH, O'Neill GK, Murphy D, Merchant RA. Frailty, length of stay and cost in hip fracture patients. Osteoporos Int. 2022 (in press). doi:10.1007/s00198-022-06553-1.

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Publiée

2023-11-17

Comment citer

1.
Saraiva AP, Moreira SS, Paiva C, Peixoto PA, Laíns J. Fragility Fracture Prevention Treatment in a Continued Care Facility: An Opportunity for Intervention. SPMFR [Internet]. 17 nov. 2023 [cité 10 nov. 2024];35(3):91-6. Disponible sur: https://spmfrjournal.org/index.php/spmfr/article/view/484

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