Lack of diagnosis and treatment of osteoporosis in men and women after hip fracture
Lack of diagnosis and treatment of osteoporosis in men and women after hip fracture
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DOI：
10.1592/phco.23.2.190.32090
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发表时间：
2003-02-01
期刊：
影响因子：
4.1
通讯作者：
McDermott, MT
中科院分区：
文献类型：
--
作者：
Follin, SL;Black, JN;McDermott, MT
研究目的。确定因低创伤髋部骨折而入住大学教学医院的男性和女性是否在入院期间或入院后1年内诊断、评估或治疗骨质疏松症。回顾性病历审查。设置。科罗拉多州丹佛市科罗拉多大学医院。1993年1月至1998年12月收治的118例低创伤髋部骨折患者。人口统计学资料，病史和社会史，处方药，临床结果，以及骨质疏松症的诊断，评估和治疗的信息，从指数髋部骨折的住院病历中提取。髋关节骨折后第一年的类似数据从医院系统内随访患者的门诊病历中提取。骨折时的平均+/- SD年龄为70 - 15岁; 43例患者为男性，75例为女性。18%的患者既往有髋部骨折史，4%有脊椎骨折史，6%报告既往有手腕骨折。在出院时14%的患者和随访时26%的患者的图表中记录了骨质疏松症的诊断。只有4%的住院患者和9%的随访患者接受了骨质疏松症的评估性检查，包括骨密度测定。12.5%的患者发生后续骨折。记录的骨质疏松症治疗并不常见，约75%的患者在出院或随访期间未接受骨质疏松症治疗。女性比男性更容易接受骨质疏松症的诊断、骨密度测试和骨质疏松症药物治疗。在髋部骨折患者中，骨质疏松症通常没有得到适当的诊断或治疗。
Study Objective. To determine whether men and women admitted to a university teaching hospital for a low-trauma hip fracture were diagnosed, evaluated, or treated for osteoporosis during admission or for up to I year after admission.Design. Retrospective chart review.Setting. University of Colorado Hospital, Denver, Colorado.Patients. One hundred eighteen patients admitted with a low-trauma hip fracture from January 1993-December 1998.Measurements and Main Results. Demographics, medical and social history, prescribed drugs, clinical outcomes, and information regarding the diagnosis, evaluation, and treatment of osteoporosis were abstracted from inpatient medical records for the index hip fracture. Similar data for the first year after the index hip fracture were abstracted from outpatient medical records of patients who had follow-up visits within the hospital system. Mean +/- SD age at the time of fracture was 70 15 years; 43 patients were men and 75 were women. Eighteen percent of patients had experienced a previous hip fracture, 4% had a history of vertebral fracture, and 6% reported a previous wrist fracture. The diagnosis of osteoporosis was noted in the charts of 14% of the patients at discharge and 26% of patients at follow-up. Only 4% of patients during hospitalization and 9% during follow-up received any evaluative tests for osteoporosis, including bone densitometry. Subsequent fractures occurred in 12.5% of patients. Documented treatment of osteoporosis was uncommon, with approximately 75% of patients receiving no therapy for osteoporosis on discharge or during follow-up. Women were more likely than men to receive a diagnosis of osteoporosis, bone mineral density testing, and osteoporosis drug therapy.Conclusion. In patients with hip fractures, osteoporosis is commonly not diagnosed or treated appropriately.