School of Health Sciences, Tottori University, Tottori, Japan.
Medical Affairs, Amgen K.K, Tokyo, Japan.
Arch Osteoporos. 2023 Jan 23;18(1):23. doi: 10.1007/s11657-022-01201-x.
UNLABELLED: Health records of patients hospitalized for osteoporotic fracture were analyzed. Prior to the index hospital admission, most patients were not receiving any antiosteoporotic treatment. During the index hospitalization visit, 25.5% of patients received antiosteoporotic treatment. The most common treatment regimens were active vitamin D, bisphosphonates, and teriparatide. PURPOSE: To examine the real-world treatment patterns and factors associated with receipt of treatment among Japanese patients with osteoporotic fracture. METHODS: We retrospectively analyzed health records of patients who were hospitalized for osteoporotic fracture between February 2016 and February 2018 in Japan. The type and duration of treatment with antiosteoporotic medications prescribed during hospital stays and after discharge were examined using descriptive statistics. Demographic and clinical factors (e.g., age, previous diagnoses, Charlson Comorbidity Index scores) associated with osteoporotic treatment were explored using multivariable logistic regression. RESULTS: A total of 112,275 patient medical records were evaluated, including 56,574 records from patients with hip fracture, 26,681 records from patients with vertebrae fracture, and 29,020 patients with non-vertebral non-hip fractures. Prior to the index hospital admission, most patients (91.7%, n = 102,919) were not receiving any antiosteoporotic treatment. For those receiving treatment, active vitamin D (51.1%, n = 4778) and bisphosphonates (47.5%, n = 4441) were the most common. During the index hospitalization visit, 25.5% (n = 28,678) of patients received treatment for their fracture, including active vitamin D (n = 17,074), bisphosphonates (n = 10,007), and teriparatide (n = 4561). Upon discharge, 41.5% (n = 46,536) of patients returned to their home and 34.3% (n = 38,542) of patients were transferred to a different hospital or medical care facility. Variables associated with receipt of treatment at follow-up included older age, previous diagnoses of osteoporosis and fracture, and higher Charlson Comorbidity Index scores. CONCLUSION: Despite osteoporotic fracture being a major health concern within older Japanese populations, treatment with antiosteoporotic medication regimens remains generally low.
目的：考察日本骨质疏松性骨折患者的实际治疗模式和与治疗相关的因素。
方法：我们回顾性分析了 2016 年 2 月至 2018 年 2 月期间在日本因骨质疏松性骨折住院的患者的健康记录。使用描述性统计方法检查住院期间和出院后开具的抗骨质疏松药物的治疗类型和持续时间。使用多变量逻辑回归探讨与骨质疏松治疗相关的人口统计学和临床因素（如年龄、既往诊断、Charlson 合并症指数评分）。
结果：共评估了 112275 份患者病历，其中髋部骨折患者 56574 份、椎体骨折患者 26681 份、非椎体非髋部骨折患者 29020 份。在指数入院前，大多数患者（91.7%，n=102919）未接受任何抗骨质疏松治疗。对于接受治疗的患者，活性维生素 D（51.1%，n=4778）和双膦酸盐（47.5%，n=4441）是最常见的治疗药物。在指数住院期间，25.5%（n=28678）的患者接受了骨折治疗，包括活性维生素 D（n=17074）、双膦酸盐（n=10007）和特立帕肽（n=4561）。出院时，41.5%（n=46536）的患者返回家中，34.3%（n=38542）的患者转至其他医院或医疗机构。与随访时接受治疗相关的变量包括年龄较大、既往骨质疏松和骨折诊断以及更高的 Charlson 合并症指数评分。
结论：尽管骨质疏松性骨折是日本老年人群中的一个主要健康问题，但抗骨质疏松药物治疗方案的总体使用率仍然较低。
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