Gómez Navarro Rafael, González García Paloma, Martín Hernández Carlos, Castro Sauras Ángel, Valdearcos Enguídanos Santiago
Centro de Salud Teruel Centro. Teruel. España.
Hospital San José. Teruel. España.
Rev Esp Salud Publica. 2017 Jan 2;91:e201701002.
Osteoporosis should be prevented, diagnosed and treated, preferably before the fragility fracture occurs. The objective was to analyze primary and secondary interventions carried out in individuals diagnosed with femur fragility fracture at Teruel in 2014.
Descriptive retrospective study. Variables assessed were sex, age, main health district, place of residence, basal functional situation, diagnosis on osteoporosis, hip or vertebral fracture, loss of height, use of FRAX tool, treatment on discharge, survival and cause of exitus. Student's t-test and ANOVA were used for quantitative variables by categories and regression for linear relationships.
148 patients were included. 123 were women median age was 87 years, 123 (76,4%) were women, 27,4% of the patients were totally or severely dependent for activities of daily living and 33% of them were living in a nursing home. There was a previous history of hip fracture in 10,1%, and one or more vertebral fractures in 10,1%. FRAX® tool was not used in any case. 12,2% of patients had been treated with calcium prior to fracture, 11,5% with vitamin D, and 6,8% of them with antiosteoporotic drugs. Only 52,7% were treated for secondary prevention after discharge. At the end of follow-up, 25,7% of hip fractured patients had died. Median survivorship of deceased patients was 64,5 days. 42,3% of exitus were caused by cardiovascular disease, 23,1% by infection and 11,5% by neoplasms.
Primary pharmacologic prevention and assessment of osteoporosis or risk of fracture are unfrequent in our health district.. Although pharmacologic treatment is prescribed more frequently in Teruel than in other areas after a hip or vertebral fracture, additional measures should be taken in order to improve fragility fracture prevention.
骨质疏松症应在脆性骨折发生之前进行预防、诊断和治疗。本研究旨在分析2014年在特鲁埃尔被诊断为股骨脆性骨折的患者所接受的一级和二级干预措施。
描述性回顾性研究。评估的变量包括性别、年龄、主要健康区域、居住地、基础功能状况、骨质疏松症诊断、髋部或椎体骨折、身高降低、FRAX工具的使用、出院时的治疗、生存情况及死亡原因。采用学生t检验和方差分析对分类定量变量进行分析,并采用回归分析线性关系。
共纳入148例患者。其中123例为女性,中位年龄为87岁,123例(76.4%)为女性,27.4%的患者在日常生活活动中完全或严重依赖他人,33%的患者居住在养老院。既往有髋部骨折病史的患者占10.1%,有一处或多处椎体骨折的患者占10.1%。所有患者均未使用FRAX®工具。12.2%的患者在骨折前接受过钙治疗,11.5%接受过维生素D治疗,6.8%接受过抗骨质疏松药物治疗。出院后仅52.7%的患者接受了二级预防治疗。随访结束时,25.7%的髋部骨折患者死亡。死亡患者的中位生存期为64.5天。42.3%的死亡原因是心血管疾病,23.1%是感染,11.5%是肿瘤。
在我们的健康区域,骨质疏松症或骨折风险的一级药物预防和评估并不常见。尽管在特鲁埃尔,髋部或椎体骨折后药物治疗的处方频率高于其他地区,但仍应采取额外措施以改善脆性骨折的预防。