Beacon Hospital, Department of Orthopedics, Petaling Jaya, Malaysia.
School of Medicine, University of Notre Dame Australia, Sydney, Australia.
Arch Osteoporos. 2024 Apr 2;19(1):24. doi: 10.1007/s11657-024-01375-6.
A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific.
Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies. The current incidence of hip and other fragility fractures across the Asia Pacific region is enormous and set to escalate rapidly in the coming decades. This publication describes findings of a survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association (APOA) conducted in 2022.
The survey was developed as a collaboration between the Asia Pacific Osteoporosis and Fragility Fracture Society and the Asia Pacific Fragility Fracture Alliance, and included questions relating to aspects of care upon presentation, during surgery and mobilisation, secondary fracture prevention, and access to specific services.
In total, 521 APOA members completed the survey and marked variation in delivery of care was evident. Notable findings included: Fifty-nine percent of respondents indicated that analgesia was routinely initiated in transit (by paramedics) or within 30 minutes of arrival in the Emergency Department. One-quarter of respondents stated that more than 80% of their patients underwent surgery within 48 hours of admission. One-third of respondents considered non-hip, non-vertebral fractures to merit assessment of future fracture risk. One-third of respondents reported the presence of an Orthogeriatric Service in their hospital, and less than a quarter reported the presence of a Fracture Liaison Service.
A Call to Action for all National Orthopaedic Associations affiliated with APOA is proposed to improve the care of fragility fracture patients across the region.
脆性骨折给老年人及其家庭、医疗保健系统和国家经济带来了巨大负担。目前，整个亚太地区髋部和其他脆性骨折的发病率非常高，并将在未来几十年迅速上升。本出版物描述了对 2022 年亚太骨科协会（APOA）会员对脆性骨折管理的认识和态度进行的一项调查的结果。
该调查是由亚太骨质疏松症和脆性骨折学会以及亚太脆性骨折联盟合作开发的，包括与就诊时、手术期间和活动期间护理的各个方面、二级骨折预防以及特定服务的获取相关的问题。
共有 521 名 APOA 成员完成了调查，明显存在护理提供方面的差异。值得注意的发现包括：59%的受访者表示，在转运（由护理人员）或到达急诊科后 30 分钟内常规开始使用止痛药。四分之一的受访者表示，超过 80%的患者在入院后 48 小时内接受了手术。三分之一的受访者认为非髋部、非椎体骨折值得评估未来的骨折风险。三分之一的受访者报告其所在医院有矫形骨科服务，不到四分之一的受访者报告有骨折联络服务。
建议所有与 APOA 相关的国家骨科协会采取行动，以改善该地区脆性骨折患者的护理。
