ECE2023 Poster Presentations Calcium and Bone (83 abstracts)
The impact of a post hip fracture FLS on mortality and recurrent fracture - a tertiary medical center retrospective study
Hadar Alkobi-Weiss 1 , Adi Goldbart 2 , Lior Hassan 2 , Vera Polischuk 1,3 , Yan Press 1,3 , Ethel Siris 4 , Uri Yoel 1,5 & Merav Fraenkel 1,5
1Ben Gurion University of the Negev, Faculty of Health Science, Be’er Sheva, Israel; 2Soroka Medical Center, Clinical Research Center, Be’er Sheva, Israel; 3Soroka Medical Center, Geriatrics, Be’er Sheva, Israel; 4Columbia University Medical Center, Division of Endocrinology, New York, United States; 5Soroka Medical Center, Endocrinolgoy, Be’er Sheva, Israel
Background: Rates of osteoporosis treatment following hip fractures are low. Fracture liaison service (FLS) has been shown to increase medical treatment for osteoporosis and decrease mortality. The aim of our study was to assess the impact of in hospital FLS on mortality and second hip fracture.
Methods: This retrospective study included patients over 65 years of age, insured by “Clalit” health service who were admitted to Soroka University Medical Center (SUMC) for rehabilitation at the Geriatrics department following the surgical repair of hip fracture. We compared rates of the composite outcome of mortality and/or second hip fracture in two equal time periods: before and after the implementation of SUMC FLS. Data were captured from the electronic medical charts including mortality, demographics, medical history, drug purchase and lab before and after hip fracture.
Results: 319 and 667 patients fulfilled study criteria in the pre and post FLS periods, respectively. Baseline characteristics of both cohorts were similar excluding eGFR that was lower and rates of PPI and steroid use that were higher in the FLS cohort. Rates of endocrine consultation (93.4% vs 3.4% P<001), performance of DXA-BMD scan (42.3% vs. 7.5% P<0.001), parenteral anti osteoporosis treatment (65.2% vs 3.1% P<0.001) were higher in the FLS cohort, while use of oral bisphosphonates was lower (26.1% vs 56/4% P<0.001). Multivariable cox regression adjusted for age, comorbidities (expressed as the Charlson comorbidity index) and FIM (functional independence measure) score, demonstrated that the implementation of the FLS decreased the composite outcome of recurrent hip fracture and mortality only in patients under age 80 OR 0.55 (95% CI 0.36-0.83; P=0.004).
Conclusions: Implementation of in hospital post hip fracture FLS increased rates of endocrine consultation, performance of DXA BMD and rates of parenteral treatment for osteoporosis. The FLS decreased the composite outcome of mortality and second fracture among patients under age 80.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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