英格兰和威尔士髋关节骨折后二级预防的当前方法——使用国家髋关节骨折数据库（NHFD）分析 2016 年至 2020 年的趋势

Current approaches to secondary prevention after hip fracture in England and Wales - an analysis of trends between 2016 and 2020 using the National Hip Fracture Database (NHFD).

机构信息

Fracture Liaison Service Database (FLSDB) Clinical Fellow, Royal College of Physicians, NDORMS, University of Oxford, London, UK.

FLSDB Lead, Royal College of Physicians, NDORMS, University of Oxford, London, UK.

出版信息

Arch Osteoporos. 2023 Jul 10;18(1):93. doi: 10.1007/s11657-023-01282-2.

DOI:10.1007/s11657-023-01282-2

PMID:37428295

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10333382/

Abstract

UNLABELLED

Hip fractures are strong risk factors for further fractures. However, using the National Hip Fracture Database, we observed that in England and Wales, 64% of patients admitted on oral bisphosphonates were discharged on the same and injectable drug use varies from 0-67% and 0.2%-83.6% were deemed "inappropriate" for bone protection. This variability requires further investigation.

INTRODUCTION

A key aim for the National Hip Fracture Database (NHFD) is to encourage secondary fracture prevention of the 75,000 patients who break their hip annually in the UK, through bone health assessment and appropriate provision of anti-osteoporosis medication (AOM). We set out to describe trends in anti-osteoporosis medication prescription and examine the types of oral and injectable AOMs being prescribed both before and after a hip fracture.

METHODS

We used data freely available from the NHFD www.nhfd.co.uk to analyse trends in oral and injectable AOM prescription across a quarter of a million patients presenting between 2016 and 2020, and more detailed information on the individual type of AOM prescribed for 63,705 patients from 171 hospitals in England and Wales who presented in 2020.

RESULTS

Most patients (88.3%) are not taking any AOM when they present with a hip fracture. Half of all patients (50.8%) were prescribed AOM treatment by the time of discharge, but the proportion deemed 'inappropriate for AOM' varied hugely (0.2-83.6%) in different hospitals. Nearly two-thirds (64.2%) of those previously taking an oral bisphosphonate were simply discharged on the same type of medication. The total number of patients discharged on oral medication fell by over a quarter in these five years. The number discharged on injectables increased by nearly three-quarters to 14.2% over the same period, but remains hugely variable across the country, with rates ranging from 0-67% across different units.

CONCLUSION

A recent hip fracture is a strong risk factor for future fractures. The huge variability in approaches, and in particular the use of injectables, in different trauma units across England and Wales requires further investigation.

摘要

未注明

髋部骨折是进一步骨折的强危险因素。然而，通过使用国家髋部骨折数据库，我们观察到在英格兰和威尔士，64%的口服双膦酸盐入院患者出院时仍使用同一种药物，而注射用药物的使用率为 0-67%，且有 0.2%-83.6%的药物被认为“不适合”用于骨骼保护。这种可变性需要进一步调查。

引言

国家髋部骨折数据库（NHFD）的一个主要目标是通过对英国每年 75000 名髋部骨折患者进行骨骼健康评估和适当提供抗骨质疏松药物（AOM），鼓励对二次骨折进行预防。我们旨在描述抗骨质疏松药物处方的趋势，并检查髋部骨折前后开具的口服和注射用 AOM 类型。

方法

我们使用 NHFD 网站上免费提供的数据，分析了 2016 年至 2020 年期间 25 万髋部骨折患者的口服和注射用 AOM 处方趋势，以及英格兰和威尔士 171 家医院 63705 名患者的更详细的 AOM 类型信息，这些患者于 2020 年就诊。

结果

大多数患者（88.3%）在髋部骨折就诊时未服用任何 AOM。有一半的患者（50.8%）在出院时接受了 AOM 治疗，但不同医院认为“不适合 AOM”的比例差异很大（0.2-83.6%）。近三分之二（64.2%）之前服用过口服双膦酸盐的患者只是出院时使用相同类型的药物。在这五年中，出院时服用口服药物的患者数量减少了四分之一以上。在此期间，出院时使用注射剂的患者数量增加了近四分之三，达到 14.2%，但在全国范围内仍然差异巨大，不同单位的使用率从 0-67%不等。