Management of Hip Fractures at an Academic Center: Challenges and Opportunities
| Autor: | Ghada El-Hajj Fuleihan, Randa Saad, Maya Beydoun |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male Pediatrics medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Osteoporosis 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine medicine Vitamin D and neurology Humans Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine Lebanon education Aged Quality of Health Care Retrospective Studies Aged 80 and over education.field_of_study Hip fracture Academic Medical Centers Vitamin d supplementation business.industry Hip Fractures Medical record Care gap Middle Aged medicine.disease Referral center Female 030101 anatomy & morphology business |
| Zdroj: | Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry. 23(4) |
| ISSN: | 1094-6950 |
| Popis: | Objective: To assess characteristics of patients with hip fractures and investigate the extent of osteoporosis-related care they receive at a tertiary referral center in Lebanon. Methods: A retrospective review of charts of 400 patients admitted with a hip fracture to the American University of Beirut-Medical Center, between January 1, 2011 and December 31, 2015. We reviewed medical records of adults admitted with a nonpathologic/nontraumatic hip fracture, and evaluated basic demographics and relevant clinical information, associated risk factors, and the management received. Results: The mean age of the population was 78 ± 10 years and men constituted 37%. Women were more likely to be assessed and/or treated. On admission, 21% were taking calcium and 18% vitamin D supplementation. During hospitalization, vitamin D level was assessed in only 39% of patients; a dietary and an osteoporosis consult were requested on only 32% and 22% of the cases, respectively. One-fourth to a third of patients were discharged on calcium or vitamin D, and less than 5% on bisphosphonates. Bone mineral density was measured in a minority although 21% had a history of previous contralateral hip fracture. One year mortality rate in a subset where follow-up available was 12% in men and 7% in women. Conclusion: A large care gap in the management of patients admitted with hip fracture persists despite clear national osteoporosis guidelines. This study provides a strong impetus for establishing and monitoring a fracture liaison service to understand and address barriers to providing optimal care to patients with osteoporosis. |
| Databáze: | OpenAIRE |
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