Hospitals with fracture liaison services see fewer recurrent fractures among the elderly
MONDAY, March 9, 2020 (HealthDay News) — Hospitals’ implementation of fracture liaison services (FLS) is associated with a reduced risk for recurrent fracture among older patients, according to a study published online Feb. 25 in the Journal of Bone and Mineral Research.
Kristian F. Axelsson, M.D., from Skaraborg Hospital in Skövde, Sweden, and colleagues used electronic health record data (2012 to 2017) to identify 21,083 patients from four hospitals in Western Sweden, two with FLS (15,449 patients) and two without (5,634 patients). All patients were ≥50 years (mean age, 73.9 years; 76 percent women) and had a major osteoporotic index fracture (hip, clinical spine, humerus, radius, and pelvis). In an intention-to-treat analysis, all patients with an index fracture during the FLS period (13,946 patients) were compared to all patients in the period prior to FLS implementation (7,137 patients). Time periods corresponding to the FLS hospitals were used for the non-FLS hospitals.
The researchers found that the risk for recurrent fracture was 18 percent lower in the FLS period versus the control period (hazard ratio, 0.82). This yielded a three-year number needed to screen of 61, which did not change after adjustment for clinical risk factors. No change in recurrent fracture rate was observed in hospitals without FLS.
“The results show that simple changes in our care routines have the intended effect, with fewer fractures as a result,” a coauthor said in a statement. “It’s now particularly important for the extremely few hospitals that have fracture liaison services to become more numerous, to reduce inequality in care, for the good of the patients.”
Several authors disclosed financial ties to the pharmaceutical industry.
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