Clinical-epidemiological profile of the patient attended in a fracture liaison service (FLS) of a regional hospital in north-west of Spain

A Marchán-López; B A Castro-Conde; J Cambón-Cotelo; V Quevedo-Vila; J López-Castro; en nombre del Equipo FLS-HPM

doi:10.1016/j.recot.2023.02.013

Clinical-epidemiological profile of the patient attended in a fracture liaison service (FLS) of a regional hospital in north-west of Spain

Rev Esp Cir Ortop Traumatol. 2023 May-Jun;67(3):T210-T215. doi: 10.1016/j.recot.2023.02.013. Epub 2023 Mar 1.

[Article in English, Spanish]

Authors

A Marchán-López¹, B A Castro-Conde¹, J Cambón-Cotelo², V Quevedo-Vila³, J López-Castro⁴; en nombre del Equipo FLS-HPM

Affiliations

¹ Servicio de Medicina Interna, Hospital Publico de Monforte, Lugo, España.
² Servicio de Traumatología, Hospital Público de Monforte, Lugo, España.
³ Unidad de Reumatología, Servicio de Medicina Interna, Hospital Publico de Monforte, Lugo, España.
⁴ Servicio de Medicina Interna, Hospital Publico de Monforte, Lugo, España. Electronic address: jlcastro126@hotmail.com.

PMID: 36863519
DOI: 10.1016/j.recot.2023.02.013

Abstract

Introduction: Hip fractures constitute a capital public health issue associated with aging and frailty because of its impact on both quality of life and morbidity and mortality in older people. Fracture liaison services (FLS) have been proposed as tools to minimize this emergent problem.

Material and methods: A prospective observational study was conducted with 101 patients treated for hip fracture by the FLS of a regional hospital between October 2019 and June 2021 (20 months). Epidemiological, clinical, surgical, and management variables were collected during admission and up to 30 days after discharge.

Results: Mean age of patients was 87.6 ± 6.1 years and 77.2% were female. Some degree of cognitive impairment was detected at admission in 71.3% of patients using the Pfeiffer questionnaire, and 13.9% were nursing home residents, and 76.24% could walk independently before the fracture. Fractures were more commonly pertrochanteric (45.5%). Patients were receiving antiosteoporotic therapy in 10.9% of cases. The median surgical delay from admission was 26 h (RIC 15-46 h), the median length of stay was 6 days (RIC 3-9 days) and in-hospital mortality was 10.9%, and 19.8% at 30 days, with a readmission rate of 5%.

Discussion: Patients treated in our FLS at the beginning of its activity were similar to the general picture in our country in terms of age, sex, type of fracture, and proportion of patients treated surgically. A high mortality rate was observed, and low rates of pharmacological secondary prevention were followed at discharge. Clinical results of FLS implementation in regional hospitals should be assessed prospectively in order to decide their suitability.

Keywords: Fractura de cadera; Fracture liaison services; Hip fracture; Morbidity; Morbilidad; Mortalidad; Mortality; Multidisciplinary unit; Unidad multidisciplinar; servicios de enlace de fracturas.