Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34093, Istanbul, Turkey.
Department of Public Health, Epidemiology and Health Economics, Liège Medical School, University of Liège, Liège, Belgium.
Arch Osteoporos. 2021 Jun 26;16(1):103. doi: 10.1007/s11657-021-00967-w.
Orthogeriatrics is a team approach that aims to provide adequate and timely intervention for individuals suffering from fragility fractures, particularly hip fractures. These patients are mostly the frailest older adults. The aim of orthogeriatrics is to re-gain functionality as early as possible and to decrease disability and mortality. Some developed countries have established orthogeriatric services, while many others, including Turkey, have so far not. Here, to identify areas for improvement, we outline the status of the orthogeriatrics in older adults in Turkey.
We present clear calls for action, emphasizing possible and noteworthy areas for improvement.
Our proposals include the need for an easily applied, short version of comprehensive geriatric assessment; appropriate laboratory testing on admission; paracetamol with a special emphasis in its dosings and clues for state-of-the-art analgesic management; the essential need to introduce oral nutritional supplementation, irrespective of nutritional status; the need for vitamin D commencement, in almost all patients; and starting osteoporosis treatment in fracture hospitalization, whenever appropriate. Last but not least, the ever-increasing prerequisite to establish "fracture liaison services" is stipulated.
We suggest that our recommendations offer great potential in Turkey, for the improvement of frail fracture patients' care. We call the other countries that do not have established orthogeriatric lines to model our approach to improve the management of fracture patients globally.
矫形老年医学是一种团队方法,旨在为患有脆性骨折(尤其是髋部骨折)的患者提供充分和及时的干预。这些患者大多是最脆弱的老年人。矫形老年医学的目的是尽早恢复功能,减少残疾和死亡率。一些发达国家已经建立了矫形老年医学服务,而许多其他国家,包括土耳其,迄今尚未建立。在这里,为了确定需要改进的领域,我们概述了土耳其老年人群中矫形老年医学的现状。
我们提出了明确的行动呼吁,强调了可能需要改进和值得关注的领域。
我们的建议包括需要一个易于应用的、简短的综合老年评估版本;入院时进行适当的实验室检查;特别强调扑热息痛的剂量和最先进的镇痛管理线索;无论营养状况如何,都必须引入口服营养补充剂;几乎所有患者都需要开始补充维生素 D;在骨折住院时开始骨质疏松症治疗,如果合适的话。最后但同样重要的是,规定了建立“骨折联络服务”的日益增长的前提条件。
我们建议我们的建议在土耳其具有很大的潜力,可以改善脆弱骨折患者的护理。我们呼吁尚未建立矫形老年医学服务的其他国家效仿我们的方法,以改善全球骨折患者的管理。