Abstract
Osteoporosis medication in fragility fracture patients is associated with better outcomes. However, limited studies have investigated whether fracture types affect outcomes among patients undergoing treatment. We performed a secondary data analysis on participants from a fracture liaison service and an osteoporosis medication management service. Participants (n = 974) were regrouped into hip fracture (HF), vertebral fracture (VF), HF + VF, and NO HF/VF groups at baseline. Bivariate and multivariate logistic regressions were performed to identify baseline correlates on one-year mortality, incident refractures, and falls. Baseline characteristics were different among fracture groups. The HF group was oldest, with the lowest body mass index (BMI), lowest FRAX® T-score and had the highest 10-year fracture risk. After intervention, the HF group still had the highest mortality, but the HF + VF group had the highest refracture and incident fall rates. In the multivariate regression analysis, prevalent HF and VF, lower BMI and albumin level, and having chronic kidney disease or cancer were associated with higher mortality rates. HF + VF patients had the highest refracture risk. Prevalent HF and VF, older age and higher BMI, and having cancer or osteoarthritis were associated with a greater fall risk. HF and VF are associated with adverse outcomes, even under an optimal fracture care.
Highlights
® hip fracture (HF) group was oldest, with the lowest body mass index (BMI), lowest FRAX T-score and had the highest 10-year fracture risk
To identify patients with a risk of adverse outcomes despite optimal care, we primarily aim to investigate whether fracture types or other participant characteristics contribute to subsequent fractures, incident falls, and mortality among participants within the Fracture liaison services (FLSs) and management service (MMS) programs
The follow-up rate was highest as 99.32% for NO HF/vertebral fracture (VF) group but lowest as 87.35% for HF group
Summary
® HF group was oldest, with the lowest body mass index (BMI), lowest FRAX T-score and had the highest 10-year fracture risk. Prevalent HF and VF, older age and higher BMI, and having cancer or osteoarthritis were associated with a greater fall risk. Osteoporotic fractures are associated with higher mortality rates, subsequent fractures, healthcare costs and lower function and quality of life. Some studies have described that being enrolled in an FLS reduced the subsequent fracture rate and improved mortality[8,9,10] compared with usual care while cooperating with effective osteoporosis treatments[11]. The parameters to predict subsequent fractures, incident falls, and mortality among those enrolled in the optimal osteoporosis management program are limited. To identify patients with a risk of adverse outcomes despite optimal care, we primarily aim to investigate whether fracture types or other participant characteristics contribute to subsequent fractures, incident falls, and mortality among participants within the FLS and MMS programs. The secondary aim is to investigate whether lifestyles such as exercise habits, use of calcium and vitamin D3 supplementation, and adequate protein intake are improved after these programs
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