Rheumatology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio - School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia.
Unidad de Reumatología. Departamento Medicina Interna, Hospital Universitario San Ignacio, Kra 7 No. 40-62, Bogotá, Colombia.
Arch Osteoporos. 2019 Sep 5;14(1):95. doi: 10.1007/s11657-019-0646-6.
Our study describes the clinical characteristics of patients with fragility fractures. It also shows there is a low knowledge about osteoporosis and its relation to fractures, in addition to the very poor adherence to medical advice and treatment.
Osteoporosis is a systemic skeletal disease associated with an increased risk of fragility fractures and is a public health problem worldwide due to population aging. Early osteoporosis diagnosis and treatment is very important for reducing the incidence of fragility fractures and the resulting complications. Our study describes the clinical characteristics of patients with fragility fractures and their risk factors, evaluates the level of knowledge that patients have about osteoporosis, and follows-up on each case to establish if, after the fracture, a densitometric diagnosis was made and the patient received specific treatment in his outpatient follow-up through his health insurance plan.
A descriptive cross-sectional study was carried out in a university hospital in Bogotá, Colombia. The data was collected by means of a questionnaire, administered to all patients admitted by the orthopedic emergency department with a diagnosis of fragility fracture. After discharge, a telephone follow-up was done every 3 months for 1 year, and patients were asked if they had already had the dual X-ray absorptiometry (DXA) scan and if they had begun osteoporosis treatment.
A total of 111 patients with an average age of 74.4 years (± 11.3 years), of which 84 (75.6%) were women, all consulted for osteoporotic fracture at the orthopedic emergency department of the hospital. Hip fracture was the most frequent (51.4%), followed by vertebral (23.4%), wrist (22.5%), and humerus (4.5%) fracture. A total of 49.5% (n = 55) of the patients did not know what osteoporosis is; 58.6% (n = 65) did not know that fracture is the main complication of this disease, and 62.2% (n = 69) did not associate fractures with osteoporosis. All patients were educated about osteoporosis and the importance of diagnosing and treating it. Patients were given a medical order to have a DXA scan upon discharge; however, only 24.3% (n = 27) had the DXA scan in the first year of the fracture. A total of 33.3% (n = 37) received calcium plus vitamin D, and only 9.9% (n = 11) received osteoporosis treatment (7 bisphosphonate patients and 4 denosumab). No patient received osteoformative therapy.
Our study shows that Colombian patients have little knowledge about osteoporosis and its relationship with fragility fractures. It also shows that densitometries are not done and, what is worse, patients with a diagnosis of fracture have limited access to treatment after discharge.
本研究描述了脆性骨折患者的临床特征。结果表明，患者对骨质疏松症及其与骨折的关系知之甚少，此外，对医嘱和治疗的依从性也很差。
骨质疏松症是一种全身性骨骼疾病，与脆性骨折的风险增加有关，由于人口老龄化，已成为全球公共卫生问题。早期诊断和治疗骨质疏松症对于降低脆性骨折的发生率和由此产生的并发症非常重要。我们的研究描述了脆性骨折患者的临床特征及其危险因素，评估了患者对骨质疏松症的了解程度，并对每个病例进行随访，以确定骨折后是否进行了双能 X 线吸收法（DXA）诊断，以及患者是否在其门诊随访中通过其健康保险计划接受了特定的治疗。
这是一项在哥伦比亚波哥大的一所大学医院进行的描述性横断面研究。通过问卷收集所有因脆性骨折而被骨科急诊收治的患者的数据。出院后，每 3 个月进行一次电话随访，为期 1 年，询问患者是否已经进行了双能 X 线吸收法（DXA）扫描，以及是否开始骨质疏松症治疗。
共纳入 111 例平均年龄为 74.4 岁（±11.3 岁）的患者，其中 84 例（75.6%）为女性，均因骨质疏松性骨折到医院骨科急诊就诊。最常见的骨折部位为髋部（51.4%），其次为椎体（23.4%）、腕部（22.5%）和肱骨（4.5%）骨折。共有 49.5%（n=55）的患者不知道什么是骨质疏松症；58.6%（n=65）不知道骨折是这种疾病的主要并发症，62.2%（n=69）不知道骨折与骨质疏松症有关。所有患者都接受了关于骨质疏松症以及诊断和治疗的重要性的教育。患者出院时被开具了进行 DXA 扫描的医嘱，但在骨折后的第一年仅有 24.3%（n=27）进行了 DXA 扫描。共有 33.3%（n=37）接受了钙加维生素 D 治疗，仅有 9.9%（n=11）接受了骨质疏松症治疗（7 例双磷酸盐患者和 4 例 denosumab）。没有患者接受成骨治疗。
本研究表明，哥伦比亚患者对骨质疏松症及其与脆性骨折的关系知之甚少。此外，DXA 检查并未进行，更糟糕的是，诊断为骨折的患者在出院后获得治疗的机会有限。
