Arcidiacono G P, Ceolin C, Sella S, Camozzi V, Bertocco A, Torres M O, Rodà M G, Cannito M, Berizzi A, Romanato G, Venturin A, Cianci V, Pizziol A, Pala E, Cerchiaro M, Savino S, Tessarin M, Simioni P, Sergi G, Ruggieri P, Giannini S
Clinica Medica 1, Department of Medicine, Azienda Ospedale-Università Padova, Padua, Italy.
Department of Medicine - DIMED, Division of Metabolic Disease (DIMED), University of Padova, Padua, Italy.
J Endocrinol Invest. 2025 Jan;48(1):99-108. doi: 10.1007/s40618-024-02425-z. Epub 2024 Jul 6.
Osteoporotic fragility fractures (FF), particularly those affecting the hip, represent a major clinical and socio-economic concern. These fractures can lead to various adverse outcomes, which may be exacerbated by the presence of sarcopenia, especially among older and frail patients. Early identification of patients with FF is crucial for implementing effective diagnostic and therapeutic strategies to prevent subsequent fractures and their associated consequences.
The Hip-POS program, implemented at Azienda Ospedale-Università Padova, is a Fracture Liaison Service (FLS) program to evaluate patients aged > 50 years old admitted with fragility hip fractures, involving an interdisciplinary team. After the identification of patients with hip fractures in the Emergency Department, a comprehensive evaluation is conducted to identify risk factors for further fractures, and to assess the main domains of multidimensional geriatric assessment, including muscle status. Patients are then prescribed with anti-fracture therapy, finally undergoing periodic follow-up visits.
During the first five months, a total of 250 patients were evaluated (70.4% women, median age 85 years). Following assessment by the Hip-POS team, compared to pre-hospitalization, the proportion of patients not receiving antifracture therapy decreased significantly from 60 to 21%. The prescription rates of vitamin D and calcium increased markedly from 29.6% to 81%.
We introduced the Hip-POS program for the care of older adults with hip fractures. We aspire that our model will represent a promising approach to enhancing post-fracture care by addressing the multifactorial nature of osteoporosis and its consequences, bridging the gap in secondary fracture prevention, and improving patient outcomes.
骨质疏松性脆性骨折（FF），尤其是髋部骨折，是一个重大的临床和社会经济问题。这些骨折可导致各种不良后果，而肌肉减少症的存在可能会加剧这些后果，尤其是在老年和体弱患者中。早期识别FF患者对于实施有效的诊断和治疗策略以预防后续骨折及其相关后果至关重要。
帕多瓦大学医院实施的髋部骨折预防与优化护理（Hip-POS）项目是一项骨折联络服务（FLS）项目，旨在评估年龄>50岁的脆性髋部骨折住院患者，该项目涉及一个跨学科团队。在急诊科确定髋部骨折患者后，进行全面评估以确定进一步骨折的风险因素，并评估多维度老年评估的主要领域，包括肌肉状况。然后为患者开抗骨折治疗药物，最后进行定期随访。
在最初的五个月里，共评估了250名患者（70.4%为女性，中位年龄85岁）。经过Hip-POS团队评估，与住院前相比，未接受抗骨折治疗的患者比例从60%显著降至21%。维生素D和钙的处方率从29.6%显著提高到81%。
我们引入了Hip-POS项目来护理老年髋部骨折患者。我们希望我们的模式将代表一种有前景的方法，通过解决骨质疏松症及其后果的多因素性质、弥合二级骨折预防的差距以及改善患者预后，来加强骨折后护理。
