Establishing a hospital based fracture liaison service to prevent secondary insufficiency fractures

INTERNATIONAL JOURNAL OF SURGERY

卷:54

Review

Noordin, Shahryar¹  Allana, Salim²  Masri, Bassam A.³ 

[1] Aga Khan Univ, Orthopaed Surg, Karachi, Pakistan

[2] Emory Univ, Dept Epidemiol, Rollins Sch Publ Hlth, 1518 Clifton Rd NE, Atlanta, GA 30322 USA

[3] Univ British Columbia, Dept Orthopaed, Vacnouver, BC, Canada

关键词: Osteoporosis;    Fragility fracture;    Insufficiency fracture;    Fracture liaison service;   

DOI  :  10.1016/j.ijsu.2017.09.010

来源: Elsevier

【 摘 要 】

In the aging population worldwide, osteoporosis is a relatively common condition and a major cause of long-term morbidity. Initial fragility fractures can lead to subsequent fractures. After a vertebral fracture, the risk of any another fracture increases 200% and that of a subsequent hip fracture increases 300%. For starting a hospital based Fracture Liaison Service (FLS) program, the nucleus is based on a physician champion, a FLS coordinator, and a nurse manager. A Fracture Liaison Service (FLS) is a multidisciplinary system approach to reducing subsequent fracture risk in patients with a recent fragility fracture due to compromised bone health by identifying them at or close to the time when they are treated at the hospital for fracture and providing them with easy access to osteoporosis care. It has been shown that when compared to other models such as referral letters to primary care physicians or endocrinologists, the FLS model results in a higher rate of diagnosis and treatment with less attrition in the posffracture phase. Insufficiency fracture care requires more than surgery to stabilize a fractured bone. The FLS program provides an opportunity to treat osteoporosis from a public health perspective rather than leaving this to the whims of individual physicians. This is achieved by providing a seamless integration of care by health care providers, nursing staff and administration. The FLS can be adapted to any model of care including academic health systems. FLS provides a holistic approach to identify patients as well as to provide evidence-based interventions to prevent subsequent fractures. The long term goal is that internationally FLS will result in in decreased fracture-related morbidity, mortality and overall health care expenditure. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

Free