Department of Orthopaedic Surgery, Saitama Jikei Hospital, 208, Ishihara 3, Kumagaya, Saitama, 360-0816, Japan.
Osteoporosis Liaison Service, Saitama Jikei Hospital, 208, Ishihara 3, Kumagaya, Saitama, 360-0816, Japan.
Arch Osteoporos. 2021 Apr 22;16(1):75. doi: 10.1007/s11657-021-00924-7.
A fracture liaison service (FLS) was established in England to support patients with fragility fractures, and it was introduced in Japan as the osteoporosis liaison service (OLS). The study aim was to determine if the Japanese OLS/FLS prevents secondary fractures in patients with fragility fractures and assess the value of the OLS/FLS. Our OLS/FLS evaluated the status of osteoporosis in patients and their life circumstances. Additionally, it introduced osteoporosis therapies during the patients' hospitalization period and then continued periodical examinations and prescription of drug after discharge.
This study was conducted in consecutive patients: 400 were assigned to the non-OLS group and 406 to the OLS group. The mean age of the patients was 81.7 ± 9.7 years in the non-OLS group (154 patients with vertebral fractures and 246 with hip fractures; 100 males, 300 females) and 82.4 ± 9.3 years in the OLS group (245 patients with hip fractures and 161 with vertebral fractures; 101 males, 305 females).
During hospitalization, 74.9% of the OLS group patients started medications and 63.9% of patients continued after discharge, while 35.8% and 53.5% of non-OLS group. The incidence rate of secondary fractures was 89.8/1000 person-years in the non-OLS group, and 55.2/1000 person-years in the OLS group. The multivariate Cox hazards test showed that secondary fractures after vertebral or hip fractures increased with age, and the risk was 0.58-fold in patients in the OLS group.
OLS was effective in reducing secondary fractures in patients with osteoporosis with fragility fractures.
骨折联络服务（FLS）在英国成立，旨在为脆性骨折患者提供支持，在日本则引入骨质疏松症联络服务（OLS）。本研究旨在确定日本 OLS/FLS 是否能预防脆性骨折患者的继发性骨折，并评估 OLS/FLS 的价值。我们的 OLS/FLS 评估了患者的骨质疏松症状况及其生活环境。此外，它在患者住院期间介绍了骨质疏松症治疗方法，然后在出院后继续定期检查和开具药物处方。
这项研究连续纳入患者：400 例患者分配至非 OLS 组，406 例患者分配至 OLS 组。非 OLS 组患者的平均年龄为 81.7 ± 9.7 岁（154 例椎体骨折，246 例髋部骨折；100 例男性，300 例女性），OLS 组患者的平均年龄为 82.4 ± 9.3 岁（245 例髋部骨折，161 例椎体骨折；101 例男性，305 例女性）。
住院期间，OLS 组 74.9%的患者开始服用药物，63.9%的患者在出院后继续服用，而非 OLS 组分别为 35.8%和 53.5%。非 OLS 组继发性骨折的发生率为 89.8/1000 人年，OLS 组为 55.2/1000 人年。多变量 Cox 风险测试显示，椎体或髋部骨折后发生继发性骨折与年龄相关，OLS 组患者的风险降低 0.58 倍。
OLS 可有效降低脆性骨折伴骨质疏松症患者的继发性骨折风险。
