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. 2018 Feb;29(2):397-407.
doi: 10.1007/s00198-017-4290-y. Epub 2017 Nov 23.

Comorbidities and medication use in patients with a recent clinical fracture at the Fracture Liaison Service

L Vranken  1   2 , C E Wyers  3   4 , R Y Van der Velde  3   4 , H M Janzing  5 , S Kaarsemaker  6 , P P Geusens  7   8 , J P Van den Bergh  3   4   8
Affiliations

Comorbidities and medication use in patients with a recent clinical fracture at the Fracture Liaison Service

L Vranken et al. Osteoporos Int. 2018 Feb.

Abstract

In this cross-sectional study, two-thirds of Fracture Liaison Service (FLS) patients had comorbidities and medications associated with increased bone- or fall-related fracture risk. Bone-related and fall-related fracture risk (BRR and FRR) were associated with age and fracture type, but not with gender or BMD. Systematic evaluation of these factors leads to a more profound assessment in FLS care.

Introduction: This study is a systematic evaluation of comorbidities and medications associated with increased fracture risk in patients aged 50-90 years with a recent fracture visiting the FLS.

Methods: In this cross-sectional cohort study, comorbidities were classified according to ICD-10 and medications according to the Anatomic Therapeutic Chemical (ATC) classification and further categorized into those associated BRR and FRR.

Results: Of 1282 patients (72% women; 65 ± 9 years), 53% had at least one BRR, 46% had at least one FRR, and 66% at least one BRR and/or FRR. At least one BRR, as well as at least one FRR were associated with age, BMI, and fracture type, but not with gender or BMD. The proportion of patients with only BRR (± 20%) or only FRR (± 10%) was similar among ages, gender, BMI, fracture type, and BMD. The combination of at least one BRR and at least one FRR was significantly associated with age, BMI, and major fractures, but not with gender or BMD.

Conclusion: Comorbidities and medications associated with increased fracture risk are present in two-thirds of patients visiting the FLS. In addition, the proportion of patients having a combination of BRR and FRR increased significantly with age, BMI, and fracture severity. This indicates that systematic evaluation of these factors is important for a more profound assessment of subsequent fracture risk in FLS care.

Keywords: Fracture prevention; Fracture risk assessment; Osteoporosis.

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Conflict of interest statement

Dr. Vranken declares that she has no conflict of interest.

Dr. Wyers declares that she has no conflict of interest.

Dr. Van der Velde declares that he has no conflict of interest.

Dr. Janzing declares that he has no conflict of interest.

Dr. Kaarsemaker declares that he has no conflict of interest.

Dr. Geusens reports grants and other from Amgen, grants from Pfizer, grants from MSD, grants from UCB, grants from Abbott, grants and other from Lilly, grants from BMS, grants from Novartis, grants from Roche, and grants from Will Pharma, outside the submitted work.

Dr. Van den Bergh reports grants from Amgen, grants from Will Pharma, and grants from Eli Lilly, outside the submitted work.

Figures

Fig. 1
Fig. 1
Selection procedure of patients with a fracture
Fig. 2
Fig. 2
Proportion of patients with only bone-related fracture risks, only fall-related fracture risks, a combination of both, and none according to fracture type (a), age per decade (b), and obesity (c). The proportion of patients with only BRR (± 20%) and the proprotion of patients with only FRR (± 10%) remained constant; whereas, the proportion of patients with a combination of BRR and FRR increased significantly with fracture severity (p < .001), increasing age (p < .001), and obesity (p < .001). BRR bone-related fracture risk, FRR fall-related fracture risk
See this image and copyright information in PMC

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