Inderjeeth C A, Glennon D, Petta A
Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Intern Med J. 2006 Sep;36(9):547-51. doi: 10.1111/j.1445-5994.2006.01146.x.
Patients with fragility fractures secondary to osteoporosis are at risk of recurrent fracture. Osteoporosis is often underrecognized and undertreated. We looked at the levels of awareness, investigation and treatment of patients with fracture.
The study group included patients admitted to a tertiary teaching hospital. Postal surveys were sent to female patients over 60 years of age who had been identified in the hospital database as having International Classification of Diseases-10 codes for fracture and discharged between June 1997 and January 2002. The questionnaire had specific questions on the histories of the fractures, the risk factors, the awareness of osteoporosis, bone mineral density testing and the treatment for osteoporosis.
Of 1584 surveys posted, 366 valid questionnaires were returned. The median age of respondents was 81 years with a range of 60-99 years. Fifty-nine per cent reported one fracture, 41% two or more fractures and 65% reported a hip fracture. Forty-eight per cent of patients were aware that they had osteoporosis and 35% reported having a bone density performed. Thirty-seven per cent reported being on treatment for osteoporosis on discharge, with the majority being on treatment with calcium (34%).
This postal survey of a high-risk patient group discharged from a tertiary hospital confirm the findings from other population-based and hospital-based studies that a significant proportion of patients at risk of further fracture are not investigated or offered specific treatment for osteoporosis. Lack of awareness of underlying osteoporosis by both treating clinicians and patients is likely to be a major contributing factor.
骨质疏松继发脆性骨折患者有再次骨折的风险。骨质疏松常常未得到充分认识和治疗。我们研究了骨折患者的知晓、检查及治疗情况。
研究组包括一所三级教学医院收治的患者。向60岁以上女性患者进行邮寄调查，这些患者在医院数据库中被确定患有国际疾病分类-10编码的骨折，于1997年6月至2002年1月期间出院。问卷包含有关骨折病史、危险因素、对骨质疏松的认识、骨密度检测及骨质疏松治疗的具体问题。
共邮寄1584份调查问卷，回收有效问卷366份。受访者的年龄中位数为81岁，范围在60 - 99岁之间。59%的人报告有一次骨折，41%的人报告有两次或更多次骨折，65%的人报告有髋部骨折。48%的患者知晓自己患有骨质疏松，35%的人报告进行过骨密度检测。37%的人报告出院时正在接受骨质疏松治疗，其中大多数人接受钙治疗（34%）。
对一家三级医院出院的高危患者群体进行的此次邮寄调查证实了其他基于人群和基于医院的研究结果，即相当一部分有再次骨折风险的患者未接受骨质疏松的检查或特异性治疗。治疗医生和患者对潜在骨质疏松缺乏认识可能是一个主要促成因素。
