Department of Internal Medicine, Carlos Haya Hospital, Malaga, Spain.
Eur J Intern Med. 2012 Mar;23(2):e44-7. doi: 10.1016/j.ejim.2011.11.015. Epub 2011 Dec 21.
To study the prevalence of vertebral fractures (VF), the associated risk factors and the degree of diagnosis and prescription upon discharge in a series of hospitalized medical patients ≥50 years of age.
A cross-sectional, multicentre and observational study in which a prevalence cut-off was carried out concerning patients admitted to six Internal Medicine departments in Malaga (Spain). The main variables were the existence of a fracture in the spine lateral x-ray, the inclusion of the diagnosis of a fracture in the discharge report, and the establishment of anti-osteoporotic treatment at discharge.
254 patients were included (mean age 66.4±14.9 years). The prevalence of VF was of 14.2% (36 cases). Patients with VF presented with a higher mean age, compared to those without VF (70.14 vs. 65.7 years) (p=0.035). The means contrast for the FRAX index variable (major osteoporotic and hip fracture), grouping according to the presence of VF, did not show any statistical significance (p=0.369 and p=0.788, respectively). Only in 8.3% of the discharge reports of patients with VF had the diagnosis of VF and/or osteoporosis been recorded and the prescription of anti-osteoporotic drugs been included.
A high prevalence of asymptomatic VF is verified in medical inpatients ≥50 years of age. The FRAX index did not turn out to be predictive of the presence of VF in this population. There is an underdiagnosis of osteoporotic VF in the coding at hospital discharge. Action protocols are necessary to avoid clinical inactivity regarding this entity.
研究一系列≥50 岁住院内科患者的椎体骨折（VF）患病率、相关危险因素以及出院时诊断和处方的程度。
这是一项横断面、多中心和观察性研究，对在西班牙马拉加的 6 个内科病房住院的患者进行患病率截止值检测。主要变量是侧位 X 射线存在脊柱骨折、出院报告中包含骨折诊断以及出院时制定抗骨质疏松症治疗方案。
共纳入 254 例患者（平均年龄 66.4±14.9 岁）。VF 的患病率为 14.2%（36 例）。与无 VF 患者相比，有 VF 的患者平均年龄更高（70.14 岁比 65.7 岁）（p=0.035）。根据是否存在 VF，对 FRAX 指数变量（主要骨质疏松性骨折和髋部骨折）进行分组的均值对比无统计学意义（p=0.369 和 p=0.788）。仅有 8.3%的 VF 患者的出院报告记录了 VF 和/或骨质疏松症的诊断，并包含了抗骨质疏松药物的处方。
在≥50 岁的内科住院患者中，证实存在无症状 VF 的高患病率。FRAX 指数并未证明对该人群 VF 的存在具有预测性。在出院编码中存在骨质疏松性 VF 的诊断不足。有必要制定行动方案，避免在治疗这种疾病时出现临床不作为。
