Goode Sarah C, Beshears Jacqueline L, Goode Russell D, Wright Theresa F, King Anita, Crist Brett D
College of Nursing, University of South Alabama, Mobile, AL, USA.
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
Geriatr Orthop Surg Rehabil. 2017 Dec;8(4):238-243. doi: 10.1177/2151458517743153. Epub 2017 Nov 28.
This prospective study sought to implement a screening tool to identify and risk stratify at-risk patients for osteoporosis and evaluate patient knowledge of osteoporosis and fragility fractures in an orthopedic trauma clinic affiliated with a level 1 trauma academic center.
Of 297 eligible patients, 291 were screened and risk stratified. Patients completed an osteoporosis screening questionnaire and were risk stratified. Lifestyle advice was given to patients at low fracture risk. A dual-energy X-ray absorptiometry scan was ordered for patients at intermediate fracture risk. A referral was initiated for treatment to a bone health specialist in high fracture risk patients. Twenty patients completed a knowledge-based pretest/posttest.
A total of 291 patients were screened, which represented 97.7% of patients over the age of 50. Of those patients, 165 (56.7%) patients met criteria for further osteoporosis evaluation as they were considered either intermediate or high risk for future fractures. One hundred thirty-six (82.4%) patients were referred for bone mineral density evaluation. For the knowledge-based evaluation portion, patients had a 33% gain in knowledge ( = .0004). The largest knowledge deficit identified pertained to osteoporosis risk factors and lifestyle management.
The use of an osteoporosis screening questionnaire in the orthopedic trauma clinic produced clinically significant improvement in identification of at-risk patients. A lack of knowledge regarding osteoporosis and fragility fractures was found to exist among these patients.
The implementation of an osteoporosis screening tool to identify, risk stratify, and treat patients with osteoporosis and related fragility fractures can be successfully integrated into a busy clinical practice.
本前瞻性研究旨在实施一种筛查工具，以识别有骨质疏松症风险的患者并对其进行风险分层，并评估在一所一级创伤学术中心附属的骨科创伤诊所中患者对骨质疏松症和脆性骨折的了解情况。
在297名符合条件的患者中，291名接受了筛查和风险分层。患者完成了一份骨质疏松症筛查问卷并进行了风险分层。对骨折风险较低的患者提供了生活方式建议。对骨折风险中等的患者安排了双能X线吸收法扫描。对骨折风险高的患者启动了转介至骨健康专家处进行治疗的程序。20名患者完成了基于知识的预测试/后测试。
总共筛查了291名患者，占50岁以上患者的97.7%。在这些患者中，165名（56.7%）患者因被认为未来骨折风险为中等或高风险而符合进一步骨质疏松症评估的标准。136名（82.4%）患者被转介进行骨密度评估。对于基于知识的评估部分，患者的知识增长了33%（P = .0004）。发现最大的知识缺陷与骨质疏松症风险因素和生活方式管理有关。
在骨科创伤诊所使用骨质疏松症筛查问卷在识别有风险的患者方面产生了具有临床意义的改善。发现这些患者中存在对骨质疏松症和脆性骨折缺乏了解的情况。
实施骨质疏松症筛查工具以识别、风险分层和治疗骨质疏松症及相关脆性骨折患者可以成功地融入繁忙的临床实践中。
