Independent predictors of functional loss and refractures in patients with femur fracture

Background: In elderly patients hospitalized for a femur fracture, this study aimed to evaluate the functional evolution, and to estimate the incidence of second fractures at 6 and 18 months after hospital discharge. Patients and methods: A longitudinal prospective study was designed at an Orthogeri...

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Autores: Casanova Querol, Teresa, Cerdà Gabaroi, Dacia|||0000-0002-3701-6124, Santiago Bautista, José María|||0000-0002-6077-8207, Girós Torres, Joan, Miralles Basseda, Ramon|||0000-0002-7770-7819, Martín-Baranera, Montserrat|||0000-0002-3416-1676
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:español
OAI Identifier:oai:ddd.uab.cat:308580
Acceso en línea:https://ddd.uab.cat/record/308580
https://dx.doi.org/urn:doi:10.1016/j.medcli.2024.11.006
Access Level:acceso abierto
Palabra clave:Femur fracture
Frailty fracture
Functional loss prediction
Fracture Liaison Service
Osteoporosis
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oai_identifier_str oai:ddd.uab.cat:308580
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dc.title.none.fl_str_mv Independent predictors of functional loss and refractures in patients with femur fracture
Follow-up at 6 and 18 months in a Fracture Liaison Service
Factores predictores de la pérdida funcional y de refracturas en los pacientes con fractura de fémur
title Independent predictors of functional loss and refractures in patients with femur fracture
spellingShingle Independent predictors of functional loss and refractures in patients with femur fracture
Casanova Querol, Teresa
Femur fracture
Frailty fracture
Functional loss prediction
Fracture Liaison Service
Osteoporosis
title_short Independent predictors of functional loss and refractures in patients with femur fracture
title_full Independent predictors of functional loss and refractures in patients with femur fracture
title_fullStr Independent predictors of functional loss and refractures in patients with femur fracture
title_full_unstemmed Independent predictors of functional loss and refractures in patients with femur fracture
title_sort Independent predictors of functional loss and refractures in patients with femur fracture
dc.creator.none.fl_str_mv Casanova Querol, Teresa
Cerdà Gabaroi, Dacia|||0000-0002-3701-6124
Santiago Bautista, José María|||0000-0002-6077-8207
Girós Torres, Joan
Miralles Basseda, Ramon|||0000-0002-7770-7819
Martín-Baranera, Montserrat|||0000-0002-3416-1676
author Casanova Querol, Teresa
author_facet Casanova Querol, Teresa
Cerdà Gabaroi, Dacia|||0000-0002-3701-6124
Santiago Bautista, José María|||0000-0002-6077-8207
Girós Torres, Joan
Miralles Basseda, Ramon|||0000-0002-7770-7819
Martín-Baranera, Montserrat|||0000-0002-3416-1676
author_role author
author2 Cerdà Gabaroi, Dacia|||0000-0002-3701-6124
Santiago Bautista, José María|||0000-0002-6077-8207
Girós Torres, Joan
Miralles Basseda, Ramon|||0000-0002-7770-7819
Martín-Baranera, Montserrat|||0000-0002-3416-1676
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Medicina
dc.subject.none.fl_str_mv Femur fracture
Frailty fracture
Functional loss prediction
Fracture Liaison Service
Osteoporosis
topic Femur fracture
Frailty fracture
Functional loss prediction
Fracture Liaison Service
Osteoporosis
description Background: In elderly patients hospitalized for a femur fracture, this study aimed to evaluate the functional evolution, and to estimate the incidence of second fractures at 6 and 18 months after hospital discharge. Patients and methods: A longitudinal prospective study was designed at an Orthogeriatric Unit after implementing a Fracture Liaison Service (FLS). The variables collected included the baseline demographic and clinical characteristics of the patients, and the outcome variables on discharge, at 6 and 18 months of follow-up. Logistic regressions models were applied to identify independent predictors of functional evolution. Results: 478 patients were admitted. Independent predictors of functional loss at follow-up were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarction, GFR < 30 ml/min/1.73 m and not receiving treatment for osteoporosis on discharge. Patients attending follow-up appointments presented improved compliance with osteoporosis treatment both at 6 and 18 months. A lower number of 2nd fractures were recorded at 18 months for patients who attended their appointments (4.8% vs 12.1%, p = 0.01). At 6 and 18 months follow-up, a lower rate of readmission was recorded (7% vs 15.3%, p = 0.006), (9.6% vs 25.6%, p < 0.0001), respectively. Conclusions: The independent predictors of functional loss at 6 and 18 months were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarct, GFR < 30 ml/min/1.73 m and not receiving treatment for osteoporosis on discharge. A lower incidence of refractures, a lower readmission rate and a better treatment compliance were observed in patients attending follow-up visits.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
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dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/308580
https://dx.doi.org/urn:doi:10.1016/j.medcli.2024.11.006
url https://ddd.uab.cat/record/308580
https://dx.doi.org/urn:doi:10.1016/j.medcli.2024.11.006
dc.language.none.fl_str_mv Español
spa
language_invalid_str_mv Español
language spa
dc.rights.none.fl_str_mv open access
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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spelling Independent predictors of functional loss and refractures in patients with femur fractureFollow-up at 6 and 18 months in a Fracture Liaison ServiceFactores predictores de la pérdida funcional y de refracturas en los pacientes con fractura de fémurCasanova Querol, TeresaCerdà Gabaroi, Dacia|||0000-0002-3701-6124Santiago Bautista, José María|||0000-0002-6077-8207Girós Torres, JoanMiralles Basseda, Ramon|||0000-0002-7770-7819Martín-Baranera, Montserrat|||0000-0002-3416-1676Femur fractureFrailty fractureFunctional loss predictionFracture Liaison ServiceOsteoporosisBackground: In elderly patients hospitalized for a femur fracture, this study aimed to evaluate the functional evolution, and to estimate the incidence of second fractures at 6 and 18 months after hospital discharge. Patients and methods: A longitudinal prospective study was designed at an Orthogeriatric Unit after implementing a Fracture Liaison Service (FLS). The variables collected included the baseline demographic and clinical characteristics of the patients, and the outcome variables on discharge, at 6 and 18 months of follow-up. Logistic regressions models were applied to identify independent predictors of functional evolution. Results: 478 patients were admitted. Independent predictors of functional loss at follow-up were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarction, GFR < 30 ml/min/1.73 m and not receiving treatment for osteoporosis on discharge. Patients attending follow-up appointments presented improved compliance with osteoporosis treatment both at 6 and 18 months. A lower number of 2nd fractures were recorded at 18 months for patients who attended their appointments (4.8% vs 12.1%, p = 0.01). At 6 and 18 months follow-up, a lower rate of readmission was recorded (7% vs 15.3%, p = 0.006), (9.6% vs 25.6%, p < 0.0001), respectively. Conclusions: The independent predictors of functional loss at 6 and 18 months were institutionalisation, severe dependence either prior to and on discharge, delirium, protein malnutrition, prior acute myocardial infarct, GFR < 30 ml/min/1.73 m and not receiving treatment for osteoporosis on discharge. A lower incidence of refractures, a lower readmission rate and a better treatment compliance were observed in patients attending follow-up visits.Objetivo: Evaluar la evolución funcional y estimar la incidencia de segundas fracturas en pacientes ancianos hospitalizados por fractura de fémur a los 6 y 18 meses del alta hospitalaria. Pacientes y métodos: Se diseñó un estudio longitudinal y prospectivo en una Unidad de Ortogeriatría tras la implementación de una Fracture Liaison Service (FLS). Las variables recogidas incluyeron características demográficas y clínicas así como variables al alta hospitalaria, a los 6 y 18 meses de seguimiento en la FLS. Se aplicaron modelos de regresión logística para identificar los predictores independientes de la evolución funcional. Resultados: Los factores predictores independientes de pérdida funcional en el seguimiento fueron: institucionalización, dependencia severa previa y al alta, delirium, desnutrición proteica, infarto agudo de miocardio previo, FG<30ml/min/1.73m² y no recibir tratamiento para la osteoporosis al alta. Los que acudieron a las citas de seguimiento presentaron mejor cumplimiento del tratamiento de la osteoporosis tanto a los 6 como a los 18 meses. Se registró un menor número de segundas fracturas a los 18 meses en los pacientes que acudieron a las visitas (4.8% vs 12.1%, p=0.01). A los 6 y 18 meses de seguimiento se registró una menor tasa de reingresos (7% vs 15.3%, p=0,006), (9.6% vs 25.6%, p<0,0001), respectivamente. Conclusiones: Los factores predictores de pérdida funcional a los 6 y 18 meses fueron la institucionalización, la dependencia severa previa y al alta, el delirium, la desnutrición proteica, el infarto agudo de miocardio previo, el FG<30ml/min/m2 y no recibir tratamiento de la osteoporosis al alta. Se observó una menor incidencia de refracturas, una menor tasa de reingresos y un mejor cumplimiento del tratamiento en los pacientes que acudieron a las visitas de seguimiento.Universitat Autònoma de Barcelona. Departament de Medicina 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/308580https://dx.doi.org/urn:doi:10.1016/j.medcli.2024.11.006reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaEspañolspaopen accesshttp://purl.org/coar/access_right/c_abf2Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3085802026-06-06T12:50:31Z
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