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Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland

BACKGROUND: Fracture liaison service (FLS) is a secondary prevention model for identification of patients at risk for fragility fractures. AIMS: This study was conducted to evaluate the number and costs of secondary prevention of low-energy fractures in the city of Kouvola in Finland. METHODS: Women...

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Autores principales: Lüthje, P., Nurmi-Lüthje, I., Tavast, N., Villikka, A., Kataja, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595226/
https://www.ncbi.nlm.nih.gov/pubmed/33811622
http://dx.doi.org/10.1007/s40520-021-01826-x
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author Lüthje, P.
Nurmi-Lüthje, I.
Tavast, N.
Villikka, A.
Kataja, M.
author_facet Lüthje, P.
Nurmi-Lüthje, I.
Tavast, N.
Villikka, A.
Kataja, M.
author_sort Lüthje, P.
collection PubMed
description BACKGROUND: Fracture liaison service (FLS) is a secondary prevention model for identification of patients at risk for fragility fractures. AIMS: This study was conducted to evaluate the number and costs of secondary prevention of low-energy fractures in the city of Kouvola in Finland. METHODS: Women aged ≥ 45 years and men ≥ 60 years treated in the emergency department with a low-energy fracture were identified. Laboratory testing, BMI, and DXA scans were performed. Fracture Risk Assessment Tool was used. The direct FLS costs were calculated. Survival was analyzed using univariate and multivariate analysis and the life-table method. RESULTS: 525 patients with 570 fractures were identified. The mean age of women was 73.8 years and of men 75.9 years. Most patients sustained wrist (31%), hip (21%) or proximal humerus (12%) fractures. 41.5% of the patients had osteoporosis according to DXA scans. 62% of patients used calcium and vitamin D daily and 38% started anti-osteoporotic medication. Protective factors for survival were: age < 80 years, female sex, and S-25OHD concentration of 50–119 nmol/L. Excess mortality was highest among patients with a fracture of the femur. The total annual direct costs of FLS were 1.3% of the costs of all fractures. DISCUSSION: Many low-energy fracture types were associated with excess mortality. The use of anti-osteoporotic medication was not optimal. CONCLUSIONS: FLS increased the catchment of low-energy fracture patients and was inexpensive. However, identification, evaluation and post-fracture assessment of patients should be expedited. Rehabilitation of hip fracture patients needs to be improved. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-021-01826-x.
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spelling pubmed-85952262021-11-24 Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland Lüthje, P. Nurmi-Lüthje, I. Tavast, N. Villikka, A. Kataja, M. Aging Clin Exp Res Original Article BACKGROUND: Fracture liaison service (FLS) is a secondary prevention model for identification of patients at risk for fragility fractures. AIMS: This study was conducted to evaluate the number and costs of secondary prevention of low-energy fractures in the city of Kouvola in Finland. METHODS: Women aged ≥ 45 years and men ≥ 60 years treated in the emergency department with a low-energy fracture were identified. Laboratory testing, BMI, and DXA scans were performed. Fracture Risk Assessment Tool was used. The direct FLS costs were calculated. Survival was analyzed using univariate and multivariate analysis and the life-table method. RESULTS: 525 patients with 570 fractures were identified. The mean age of women was 73.8 years and of men 75.9 years. Most patients sustained wrist (31%), hip (21%) or proximal humerus (12%) fractures. 41.5% of the patients had osteoporosis according to DXA scans. 62% of patients used calcium and vitamin D daily and 38% started anti-osteoporotic medication. Protective factors for survival were: age < 80 years, female sex, and S-25OHD concentration of 50–119 nmol/L. Excess mortality was highest among patients with a fracture of the femur. The total annual direct costs of FLS were 1.3% of the costs of all fractures. DISCUSSION: Many low-energy fracture types were associated with excess mortality. The use of anti-osteoporotic medication was not optimal. CONCLUSIONS: FLS increased the catchment of low-energy fracture patients and was inexpensive. However, identification, evaluation and post-fracture assessment of patients should be expedited. Rehabilitation of hip fracture patients needs to be improved. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-021-01826-x. Springer International Publishing 2021-04-03 2021 /pmc/articles/PMC8595226/ /pubmed/33811622 http://dx.doi.org/10.1007/s40520-021-01826-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Lüthje, P.
Nurmi-Lüthje, I.
Tavast, N.
Villikka, A.
Kataja, M.
Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title_full Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title_fullStr Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title_full_unstemmed Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title_short Evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in South-Finland
title_sort evaluation of minimal fracture liaison service resource: costs and survival in secondary fracture prevention—a prospective one-year study in south-finland
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595226/
https://www.ncbi.nlm.nih.gov/pubmed/33811622
http://dx.doi.org/10.1007/s40520-021-01826-x
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