Nguyen Van T, Etty-Leal Mary G, Hua Jean T
The Royal Melbourne Hospital, Victoria, Australia.
Hosp Pharm. 2019 Apr;54(2):105-111. doi: 10.1177/0018578718769564. Epub 2018 Apr 30.
The purpose of this study was to determine the proportion of patients admitted to a major tertiary teaching hospital in Australia aged 50 years and older with a confirmed neck of femur or vertebral minimal trauma fracture, who are commenced on colecalciferol supplementation by discharge, and to describe the doses prescribed. A subanalysis of a retrospective audit of electronic medical files for patients admitted with a minimal trauma fracture of the hip or vertebra between January 1, 2016, and June 30, 2016, was conducted. A total of 406 patients were screened and 64 patients were included in the audit. In this subanalysis of these 64 patients eligible for inclusion, 38 were not on any vitamin or mineral supplementation at admission. Of these, 26 patients (68.4%) had their serum colecalciferol levels measured, and 21 patients (55.2%) overall were initiated on colecalciferol. Over half of patients with a minimal trauma fracture were commenced on colecalciferol therapy, but a noteworthy proportion of patients remain untreated. Patients with colecalciferol levels are more likely to be initiated on therapy compared with those of whom levels were not taken during admission. This is a missed opportunity for intervention that may place patients at a higher risk of subsequent fracture; therefore, effective strategies should be implemented to address this treatment gap in the future.
本研究的目的是确定澳大利亚一家大型三级教学医院收治的50岁及以上确诊为股骨颈或椎体轻微创伤性骨折的患者中，出院时开始补充骨化二醇的患者比例，并描述所开的剂量。对2016年1月1日至2016年6月30日期间因髋部或椎体轻微创伤性骨折入院患者的电子病历进行回顾性审核，并进行了一项子分析。共筛查了406例患者，64例患者纳入审核。在对这64例符合纳入条件的患者进行的子分析中，38例患者入院时未进行任何维生素或矿物质补充。其中，26例患者（68.4%）检测了血清骨化二醇水平，总体上21例患者（55.2%）开始补充骨化二醇。超过一半的轻微创伤性骨折患者开始接受骨化二醇治疗，但仍有相当比例的患者未得到治疗。与入院时未检测骨化二醇水平的患者相比，检测了骨化二醇水平的患者更有可能开始接受治疗。这是一个错失的干预机会，可能会使患者面临更高的后续骨折风险；因此，未来应实施有效的策略来弥补这一治疗差距。
