Targeted optimum care approach for osteoporotic fragility fractures: tailored strategy based on risk stratification to reduce incidents of falls-an initiative by the Egyptian Academy of bone health based on the FLS national register.

Autor: El Miedany Y; Canterbury Christ Church University, England, UK., El Gaafary M; Community and Public Health, Ain Shams University, Cairo, Egypt., Gadallah N; Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt., Mahran S; Physical Medicine, Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt., Hassan W; Rheumatology and Rehabilitation, Benha University, Benha, Egypt., Fathi N; Physical Medicine, Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt., Abu-Zaid MH; Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt., Tabra SAA; Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt., Shalaby RH; Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt., Elwakil W; Rheumatology, Rehabilitation and Physical Medicine, Alexandria University, Alexandria, Egypt. walaa.ali@alexmed.edu.eg.
Jazyk: angličtina
Zdroj: Archives of osteoporosis [Arch Osteoporos] 2023 Nov 21; Vol. 18 (1), pp. 139. Date of Electronic Publication: 2023 Nov 21.
DOI: 10.1007/s11657-023-01347-2
Abstrakt: Since falling is the third cause of chronic disability, a better understanding of the frequency, severity, and risk factors of falls across diagnostic groups is needed to design and implement customized, effective fall prevention, and management programs for these individuals, particularly those at risk of sustaining a fragility fracture.
Objective: (1) To assess the incidence of falls among osteoporotic patients with fragility fractures. (2) To evaluate the potential for stratifying the people at risk of falling in bone health setting aiming to provide targeted optimum care for them.
Methods: This was a multi-center, cross-sectional, observational study. Both men and postmenopausal women, admitted with an osteoporotic fracture (whether major osteoporosis or hip fracture), were consecutively recruited for this work and managed under Fracture Liaison Service. All the patients were assessed for their Fracture risk (FRAX), falls risk (FRAS), and sarcopenia risk (SARC-F) as well as functional disability (HAQ). Blood tests for bone profile as well as DXA scan were offered to all the patients.
Results: Four hundred five patients (121 males, 284 females) were included in this work. Mean age was 70.1 (SD = 9.2) years. The incidence of falls was 64.9%. The prevalence of falls was high (64.8%) in the patients presenting with major osteoporosis fractures and in those with hip fractures (61.8%). The prevalence of fragility fractures was positively correlated with HAQ score and the SARC-F score (p = 0.01 and 0.021 respectively). Falls risk score was positively correlated with FRAX score of major osteoporotic fractures, HAQ score, and SARC-F score (p = 0.01, 0.013, and 0.003 respectively). Seventy percent of the osteopenia patients who sustained fragility fracture had high falls risk and/or SARC-F score.
Conclusion: This study highlighted the importance of falls risk stratification in osteoporotic patients presenting with fragility fractures. Identification of the patients at increased risk of falls should be a component of the standard practice.
(© 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)
Databáze: MEDLINE
Externí odkaz: