Health Outcomes in Fragility Fractures in the Spanish Registry of Osteoporotic Fractures According to the FLS Care Model
Background. Fracture Liaison Services (FLS) are the gold standard for secondary fracture prevention, but their characteristics vary depending on the care model. This study describes the differences between Orthogeriatric (FLS-ORT) and Bone Metabolism (FLS-MET) models in Spain, based on data from the...
| Autores: | , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2026 |
| País: | España |
| Institución: | Consejo Superior de Investigaciones Científicas (CSIC) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p19561 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/19561 |
| Access Level: | acceso abierto |
| Palabra clave: | Fracture Liaison Services Bone Metabolism Units Orthogeriatrics Secondary prevention Frailty fractures |
| Sumario: | Background. Fracture Liaison Services (FLS) are the gold standard for secondary fracture prevention, but their characteristics vary depending on the care model. This study describes the differences between Orthogeriatric (FLS-ORT) and Bone Metabolism (FLS-MET) models in Spain, based on data from the national osteoporotic fracture registry. Methods. We conducted a retrospective, multicenter cohort study including 8,962 patients aged >= 50 years with fragility fractures from 25 active FLS in Spain (2019-2023). Patients were classified based on the care model: FLS-ORT ( n = 3,695) or FLS-MET ( n = 5,267). Baseline characteristics, fracture types, treatment initiation, adherence, and 12-month outcomes were compared. Results. FLS-ORT patients were older (85 vs. 78 years, p < 0.001), had more comorbidities, and a higher risk of falls. Hip fractures were predominant in FLS-ORT (75.8%), while vertebral fractures were more frequent in FLS-MET ( p < 0.001). Time from fracture to FLS assessment was shorter in FLS-ORT (0.1 vs. 1.6 months, p < 0.001). At 12 months, fracture recurrence was higher in FLS-ORT (7.7 vs. 5.5 per 100 patient-years), and mortality was significantly greater ( p < 0.0001). However, osteoporosis treatment initiation (84.6%) and adherence (85.2%) were comparable across models. Conclusions. FLS are the gold standard for secondary fracture prevention. Both FLS care models (FLS-ORT and FLS-MET) were effective in reducing the risk of new fractures in patients and minimizing the impact on the quality of life of patients who suffer a fragility fracture. Future integration into a unified model assessing all fractures is anticipated. (c) 2025 The Author(s). Published by Elsevier Inc. on behalf of Instituto Mexicano del Seguro Social (IMSS).This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) |
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