Clinical–epidemiological profile of the patient attended in a Fracture Liaison Service (FLS) of a regional hospital in north-west of Spain
Hip fractures constitute a capital public health issue associated with aging and frailty because of its impact on both quality of life and morbidity and mortality in older people. Fracture Liaison Services (FLS) have been proposed as tools to minimize this emergent problem. A prospective observation...
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| Published in: | Revista española de cirugía ortopédica y traumatología Vol. 67; no. 3; pp. 210 - 215 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Spain
Elsevier España, S.L.U
01-05-2023
Elsevier |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Hip fractures constitute a capital public health issue associated with aging and frailty because of its impact on both quality of life and morbidity and mortality in older people. Fracture Liaison Services (FLS) have been proposed as tools to minimize this emergent problem.
A prospective observational study was conducted with 101 patients treated for hip fracture by the FLS of a regional hospital between October 2019 and June 2021 (20 months). Epidemiological, clinical, surgical and management variables were collected during admission and up to 30 days after discharge.
Mean age of patients was 87.6±6.1 years and 77.2% were female. Some degree of cognitive impairment was detected at admission in 71.3% of patients using the Pfeiffer questionnaire, and 13.9% were nursing home residents, and 76.24% could walk independently before the fracture. Fractures were more commonly pertrochanteric (45.5%). Patients were receiving antiosteoporotic therapy in 10.9% of cases. The median surgical delay from admission was 26h (RIC 15–46h), the median length of stay was 6 days (RIC 3–9 days) and in-hospital mortality was 10.9%, and 19.8% at 30 days, with a readmission rate of 5%.
Patients treated in our FLS at the beginning of its activity were similar to the general picture in our country in terms of age, sex, type of fracture, and proportion of patients treated surgically. A high mortality rate was observed, and low rates of pharmacological secondary prevention were followed at discharge. Clinical results of FLS implementation in regional hospitals should be assessed prospectively in order to decide their suitability.
Las fracturas de cadera constituyen un problema de salud pública capital asociado al envejecimiento y la fragilidad por su impacto en la calidad de vida y la morbimortalidad de las personas mayores. Se ha propuesto el uso de servicios de enlace de fracturas (FLS) para minimizar este problema emergente.
Estudio observacional prospectivo con 101 pacientes con fractura de cadera tratados en el FLS de un hospital regional entre octubre de 2019 y junio de 2021 (20 meses). Se recogieron variables epidemiológicas, clínicas y quirúrgicas durante el ingreso y hasta 30 días después del alta.
La edad media de los pacientes fue de 87,6±6,1 años, el 77,2% eran mujeres y el 71,3% tenían deterioro cognitivo al ingreso según el cuestionario de Pfeiffer. El 13,9% estaban institucionalizados y el 76,24% podían caminar de forma independiente antes de la fractura. Las fracturas fueron más frecuentemente pertrocantéricas (45,5%). Los pacientes recibían tratamiento antiosteoporótico en el 10,9% de los casos. La mediana de la demora quirúrgica desde el ingreso fue de 26 horas (RIC 15-46 horas), la mediana de la estancia fue de 6 días (RIC 3-9 días) y la mortalidad intrahospitalaria fue del 10,9%, y del 19,8% a los 30 días, con una tasa de reingreso del 5%.
Los pacientes tratados en nuestro FLS al inicio de su actividad eran similares a la imagen general de nuestro país en cuanto a edad, sexo, tipo de fractura y proporción de pacientes tratados quirúrgicamente. Se observó una alta tasa de mortalidad y se siguieron bajas tasas de osteoprotección al alta. Los resultados clínicos de la implantación del FLS en los hospitales regionales deben ser evaluados de forma prospectiva para decidir su idoneidad. |
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| ISSN: | 1888-4415 1988-8856 |
| DOI: | 10.1016/j.recot.2022.10.017 |