Internal Medicine Investigation Unit, Centro de Investigaciones Clínicas SURA, Medellín, Colombia.
Gestora Metodológica Grupo de Investigación Clínica y Ensayos Clínicos SURA, Medellín, Colombia.
Arch Osteoporos. 2024 Jun 20;19(1):52. doi: 10.1007/s11657-024-01409-z.
This study examined the clinical characteristics and refracture rates of Colombian patients with high- and very high-risk osteoporosis. This reveals osteoporosis diagnoses and treatment gaps. Only 5.3% of the patients were diagnosed with osteoporosis at discharge and 70.5% had refractures. This finding underscores the need for national policies to enhance osteoporosis prevention and treatment.
This study aimed to assess the clinical features and refracture rates among patients with high- and very-high-risk osteoporosis in Colombia, highlighting diagnostic and treatment gaps.
A retrospective observational study was conducted using the medical records of patients aged ≥ 50 years who experienced fragility fractures between 2003 and 2022. Clinical and demographic characteristics at the time of the initial fracture were analyzed, as well as the subsequent imminent risk (refracture rate) and the diagnosis and treatment gap.
303.982 fragility fractures occurred, and only 5.3% of patients were diagnosed with osteoporosis upon discharge. The most prevalent index fractures were forearm, vertebral, rib, and hip. Only 17.8% of the cohort had a matched osteoporosis diagnosis, indicating a low healthcare capture. Among the diagnosed patients, 10.08% were classified as high- and very high-risk of fracture, predominantly women with a mean age of 73 years. Comorbidities included diabetes, Sjögren's syndrome, and heart failure. The prevalence of osteoporosis has increased significantly from 2004 to 2022, possibly due to improved detection methods, an aging population, or a combination of both. Despite this increase, treatment delay was evident. Refractures affected 70.5% of the patients, with forearm, hip, humerus, and vertebral fractures being the most common, with a mean time of refracture of 7 months.
Significant delays were observed in the diagnosis and treatment of fragility fractures. Colombia's government and health system must address osteoporosis by implementing national policies that prioritize osteoporosis and fragility fracture prevention and reduce delays in diagnosis and treatment.
本研究旨在评估哥伦比亚高风险和极高风险骨质疏松症患者的临床特征和再骨折率，突显诊断和治疗方面的差距。
采用回顾性观察性研究方法，分析了 2003 年至 2022 年间发生脆性骨折的年龄≥50 岁患者的病历，包括初始骨折时的临床和人口统计学特征、随后的即刻风险（再骨折率）以及诊断和治疗差距。
共发生 303982 例脆性骨折，出院时仅有 5.3%的患者被诊断为骨质疏松症。最常见的骨折部位是前臂、椎体、肋骨和髋部。只有 17.8%的患者有匹配的骨质疏松症诊断，这表明医疗保健的捕获率较低。在确诊患者中，10.08%为高风险和极高风险骨折患者，主要为女性，平均年龄为 73 岁。合并症包括糖尿病、干燥综合征和心力衰竭。骨质疏松症的患病率从 2004 年到 2022 年显著增加，可能是由于检测方法的改进、人口老龄化或两者的结合。尽管患病率有所增加，但治疗延迟仍然明显。70.5%的患者发生了再骨折，最常见的再骨折部位是前臂、髋部、肱骨和椎体，再骨折的平均时间为 7 个月。
脆性骨折的诊断和治疗存在明显延迟。哥伦比亚政府和卫生系统必须通过实施国家政策来解决骨质疏松症问题，这些政策应优先考虑骨质疏松症和脆性骨折的预防，并减少诊断和治疗的延迟。
