Fragility Vertebral Compression Fractures in Postmenopausal Women: The Role of a Fracture Liaison Service Program.

BACKGROUND: As the aging population increases in the United States, so has the prevalence of osteoporosis (10.2 million adults aged 50 years and older in 2010). Programs to manage the increased incidence of fragility fractures in such patients particularly the postmenopausal women are the priority. Programs such as the Fracture Liaison Service (FLS) might be the answer. METHODS: Data of 256 postmenopausal women with vertebral compression fractures treated with vertebroplasty between 2012 and 2017 were divided into 2 groups. Group A were patients seen between 2012 and 2014 before the establishment of the FLS program at the clinic. Group B were patients seen between 2015 and 2017 who presented to the FLS program in our clinic. Data collected included demographics, refracture rates, dual-energy X-ray absorptiometry (DEXA) scan T-scores, fracture risk score (FRAX), serum calcium and vitamin D levels, and comorbid conditions. RESULTS: There were 103 female patients with a mean age of 79.75 years (standard deviation [SD] ± 10.86) in group A, while group B had 153 patients with a mean age of 75.66 years (SD ± 10.78). There was no significant difference in the DEXA scan T-scores, FRAX scores, and mean serum calcium and vitamin D levels; however, there was a significant reduction in the refracture rate for vertebral compression fractures (P = .003). CONCLUSION: FLS programs, when implemented, will have a beneficial effect in reducing refracture rates of postmenopausal women with osteoporotic fragility fractures.

Does a fracture liaison service program minimize recurrent fragility fractures in the elderly with osteoporotic vertebral compression fractures?

BACKGROUND: There is a sizable proportion of elderly, both men and women, with fragility fractures, approximately 2 million fractures per year in the United States. METHODS: A retrospective chart review of 365 patient presented between January 2012 and December 2017 with vertebral compression fractures. Pre-post study design to determine refracture between Group A (before Fracture Liaison Service (FLS)) and Group B, after. Calcium, Vitamin D, DEXA scans, FRAX scores, and refracture rates were measured. RESULTS: Mean age for group A and B were 79.0 and 74.9 years, respectively, and predominantly females. Serum calcium was higher in group B (9.51 mg/d/L versus 9.40 mg/dL) but not significant (p = 0.19). Fracture score among the groups was similar (20% versus 22%; p = 0.44). The total refracture rate for both vertebral and other fracture was significantly less in the post FLS patients, 36.5% versus 56% p-value = 0.01. CONCLUSION: FLS program benefited patients with fragility fractures by decreasing the incidence of all refracture rates.