Edwards Beatrice J, Bunta Andrew D, Simonelli Christine, Bolander Mark, Fitzpatrick Lorraine A
Northwestern University, Chicago, IL, USA.
Clin Orthop Relat Res. 2007 Aug;461:226-30. doi: 10.1097/BLO.0b013e3180534269.
Treating osteoporosis in patients with prior fractures potentially results in a 50% reduction of risk of future fractures. We retrospectively reviewed 632 patients with incident hip fractures to evaluate (1) the prevalence of prior fractures in incident hip fractures, (2) whether prior fractures led to an increase in the treatment of osteoporosis, and (3) the cost utility of osteoporosis treatment after a prior fracture. The patients were treated at three hospitals from January 2000 to June 2001 and 514 (80%) were women. A minimal trauma fracture was defined as a fracture resulting from a fall while standing or walking or falling from a height less than 4 feet. Two hundred eighty-two patients (45%) with incident hip fractures described a prior minimal trauma fracture. Osteoporosis was diagnosed in 43 (13%) women and three (5%) men. In 107 cases (17%), the incident hip fracture was the second hip fracture. A prior minimal trauma fracture did not increase treatment for osteoporosis. Presuming a 50% reduction in fracture risk with medications, treating the 282 patients with prior minimal trauma fracture would have resulted in a savings of $3.5 million.
治疗既往有骨折史的骨质疏松症患者可能会使未来骨折风险降低50%。我们回顾性分析了632例新发髋部骨折患者，以评估：（1）新发髋部骨折患者既往骨折的患病率；（2）既往骨折是否导致骨质疏松症治疗增加；（3）既往骨折后骨质疏松症治疗的成本效益。这些患者于2000年1月至2001年6月在三家医院接受治疗，其中514例（80%）为女性。轻微创伤性骨折定义为站立或行走时摔倒或从低于4英尺的高度坠落导致的骨折。282例（45%）新发髋部骨折患者描述有既往轻微创伤性骨折。43例（13%）女性和3例（5%）男性被诊断为骨质疏松症。在107例（17%）中，新发髋部骨折是第二次髋部骨折。既往轻微创伤性骨折并未增加骨质疏松症的治疗。假设药物治疗可使骨折风险降低50%，治疗282例既往有轻微创伤性骨折的患者可节省350万美元。
