Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands.
Department of Internal Medicine, Research School NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands.
BMJ Open. 2022 Jul 27;12(7):e058983. doi: 10.1136/bmjopen-2021-058983.
To evaluate the risk of subsequent fractures in patients who attended the Fracture Liaison Service (FLS), with and without incident falls after the index fracture.
A 3-year prospective observational cohort study.
An outpatient FLS in the Netherlands.
Patients aged 50+ years with a recent clinical fracture.
Incident falls and subsequent fractures.
The study included 488 patients (71.9% women, mean age: 64.6±8.6 years). During the 3-year follow-up, 959 falls had been ascertained in 296 patients (60.7%) (ie, fallers), and 60 subsequent fractures were ascertained in 53 patients (10.9%). Of the fractures, 47 (78.3%) were fall related, of which 25 (53.2%) were sustained at the first fall incident at a median of 34 weeks. An incident fall was associated with an approximately 9-fold (HR: 8.6, 95% CI 3.1 to 23.8) increase in the risk of subsequent fractures.
These data suggest that subsequent fractures among patients on treatment prescribed in an FLS setting are common, and that an incident fall is a strong predictor of subsequent fracture risk. Immediate attention for fall risk could be beneficial in an FLS model of care.
NL45707.072.13.
评估就诊于骨折联络服务（Fracture Liaison Service，FLS）的患者在发生指数骨折后有无意外跌倒事件，其再次发生骨折的风险。
一项为期 3 年的前瞻性观察性队列研究。
荷兰的一个门诊 FLS。
年龄≥50 岁、近期有临床骨折的患者。
意外跌倒和再次骨折。
本研究纳入了 488 名患者（71.9%为女性，平均年龄：64.6±8.6 岁）。在 3 年的随访期间，296 名患者（60.7%）（即跌倒者）中确定了 959 次跌倒，53 名患者（10.9%）中确定了 60 次再次骨折。其中，47 例（78.3%）骨折与跌倒有关，其中 25 例（53.2%）在首次跌倒事件发生时发生，中位数为 34 周。发生跌倒与再次骨折风险增加约 9 倍（HR：8.6，95%CI 3.1 至 23.8）相关。
这些数据表明，在 FLS 治疗环境下接受治疗的患者再次骨折较为常见，而意外跌倒事件是再次骨折风险的一个强烈预测因素。在 FLS 护理模式中，立即关注跌倒风险可能是有益的。
NL45707.072.13。
