1. Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review.
- Author
-
ONG, TERENCE, KANTACHUVESIRI, PITCHAYUD, SAHOTA, OPINDER, and GLADMAN, JOHN R. F.
- Subjects
TREATMENT of fractures ,DIAGNOSIS of bone fractures ,AGE distribution ,HOSPITAL care of older people ,CINAHL database ,ACCIDENTAL falls ,BONE fractures ,LENGTH of stay in hospitals ,MEDICAL information storage & retrieval systems ,LONG-term health care ,MEDLINE ,MORTALITY ,OSTEOPOROSIS ,SYSTEMATIC reviews ,COMORBIDITY ,SPINAL injuries ,ACTIVITIES of daily living ,TREATMENT effectiveness ,DATA analysis software ,DESCRIPTIVE statistics ,AMED (Information retrieval system) ,OLD age ,DIAGNOSIS ,THERAPEUTICS - Abstract
Background: the complex management for patients presenting to hospital with vertebral fragility fractures provides justification for the development of specific services for them. A systematic review was undertaken to determine the incidence of hospital admission, patient characteristics and health outcomes of vertebral fragility fracture patients to inform the development of such a service. Methods: non-randomised studies of vertebral fragility fracture in hospital were included. Searches were conducted using electronic databases and citation searching of the included papers. Results: a total of 19 studies were included. The incidence of hospital admission varied from 2.8 to 19.3 per 10,000/year. The average patient age was 81 years, the majority having presented with a fall. A diagnosis of osteoporosis or previous fragility fracture was reported in around one-third of patients. Most patients (75% men and 78% women) had five or more copathologies. Most patients were managed non-operatively with a median hospital length of stay of 10 days. One-third of patients were started on osteoporosis treatment. Inpatient and 1-year mortality was between 0.9 and 3.5%, and 20 and 27%, respectively, between 34 and 50% were discharged from hospital to a care facility. Many patients were more dependent with activities of daily living on discharge compared to their pre-admission level. Older age and increasing comorbidities was associated with longer hospital stay and higher mortality. Conclusion: these findings indicate that specific hospital services for patients with vertebral fragility fractures should take into consideration local hospitalisation rates for the condition, and should be multifaceted-providing access to diagnostic, therapeutic, surgical and rehabilitation interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF