Martinez-Laguna Daniel, Soria-Castro Alberto, Carbonell-Abella Cristina, Orozco-López Pilar, Estrada-Laza Pilar, Nogues Xavier, Díez-Perez Adolfo, Prieto-Alhambra Daniel
GREMPAL Research Group, Idiap Jordi Gol Primary Care Research Institute, CIBER FES ISCIII, Universitat Autonoma de Barcelona, Barcelona, Spain; Ambit Barcelona, Primary Care Department, Institut Català de la Salut, Barcelona, Spain.
Ambit Barcelona, Primary Care Department, Institut Català de la Salut, Barcelona, Spain.
Reumatol Clin (Engl Ed). 2019 Sep-Oct;15(5):e1-e4. doi: 10.1016/j.reuma.2017.10.013. Epub 2017 Nov 28.
Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP.
Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected.
Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis.
More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures.
电子病历数据库使用预先指定的诊断代码列表来识别骨折。然而，这些代码不够具体，无法区分创伤性骨折和脆性骨折。我们报告了在SIDIAP编码骨折随机样本中识别出的脆性骨折比例。
2012年有任何骨折记录（根据预先指定的ICD - 10代码）且在招募时仍存活的≥50岁患者，符合参与这项在为SIDIAP数据库（www.sidiap.org）提供数据的6个初级保健中心进行的回顾性观察研究的条件。排除既往有骨折史、无应答者以及患有痴呆或严重精神疾病的患者。收集骨折类型（创伤性与脆性）、骨骼部位和患者基本特征的数据。
在2012年记录有骨折的491/616名（79.7%）被联系患者中，331名（349处骨折）被纳入研究。最常见的骨折部位是前臂（82处）、肋骨（38处）和肱骨（32处），225/349处（64.5%）为脆性骨折，在典型骨质疏松部位比例更高：髋部，91.7%；脊柱，87.7%；以及主要骨折，80.5%。女性、老年人以及既往编码诊断为骨质疏松症的患者中这一比例更高。
SIDIAP记录的超过五分之四的主要骨折是由脆性（非创伤性）引起的，髋部骨折（92%）和椎体骨折（88%）比例更高，非主要骨折比例较低。我们的数据支持SIDIAP在骨质疏松性骨折流行病学研究中的有效性。
