Iba Kousuke, Dohke Takayuki, Takada Junichi, Sasaki Koichi, Sonoda Tomoko, Hanaka Megumi, Miyano Suichi, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
J Orthop Sci. 2018 Jan;23(1):127-131. doi: 10.1016/j.jos.2017.09.008. Epub 2017 Oct 2.
We have previously reported that the low rate of osteoporosis patients treated with anti-osteoporotic drugs following surgical treatment for the first fragility fractures by orthopaedic surgeons during 3 years from 2000 to 2003 was only 13.1%. Ten years have now passed our previous study, and we hypothesized that the rate of appropriate pharmacologic treatment for the prevention of secondary fractures has improved.
We studied 730 osteoporosis patients (102 men and 628 women; average age of 78 years, range 33-102 years) who underwent surgical treatment for fragility fractures, during 3-year period from 2010 to 2012. The 730 cases consisted of 489 hip fractures and 241 distal radius fractures. All patients were admitted and underwent surgical intervention in hospitals. Variables were examined to ascertain whether pharmaceutical treatment was performed after discharge. Based on these data, we compared results for patients in the present study with those from our previous study.
The rate of treatment with anti-osteoporosis medication in the present (16.2%) was slightly but significantly improved from that in our previous study (13.1%). The rate of pharmaceutical treatment following hip fractures increased significantly, while that following distal radius fractures showed no significant change. Regarding the categories of anti-osteoporotic drugs prescribed to the patients, the rate of treatment with bisphosphonate as a higher evidenced drug for the prevention of fractures in the present study was significantly higher than that in our previous study.
We demonstrated that the rate of pharmacologic treatment by orthopaedic surgeons and the rate of more effective anti-osteoporotic drugs prescribed to the patients following surgical intervention for the first fragility fracture in the present study were improved in comparison with those of 10 years ago.
我们之前曾报道,在2000年至2003年的3年期间,骨科医生对首次脆性骨折进行手术治疗后,接受抗骨质疏松药物治疗的骨质疏松症患者比例仅为13.1%。自我们之前的研究过去十年后,我们推测预防二次骨折的适当药物治疗比例有所提高。
我们研究了2010年至2012年3年期间因脆性骨折接受手术治疗的730例骨质疏松症患者(102名男性和628名女性;平均年龄78岁,范围33 - 102岁)。这730例病例包括489例髋部骨折和241例桡骨远端骨折。所有患者均入院并在医院接受手术干预。检查变量以确定出院后是否进行了药物治疗。基于这些数据,我们将本研究中患者的结果与我们之前研究的结果进行了比较。
本研究中抗骨质疏松药物治疗率(16.2%)较我们之前的研究(13.1%)略有但显著提高。髋部骨折后的药物治疗率显著增加,而桡骨远端骨折后的药物治疗率无显著变化。关于给患者开的抗骨质疏松药物类别,本研究中作为预防骨折证据更充分的药物双膦酸盐的治疗率显著高于我们之前的研究。
我们证明,与10年前相比,本研究中骨科医生的药物治疗率以及首次脆性骨折手术干预后给患者开的更有效的抗骨质疏松药物率均有所提高。