Osteoporos Sarcopenia.  2020 Dec;6(4):199-204. 10.1016/j.afos.2020.11.004.

The effectiveness of Police General Hospital’s fracture liaison service (PGH’s FLS) implementation after 5 years: A prospective cohort study

Affiliations
  • 1Department of Orthopedics, Police General Hospital, Bangkok, 10330, Thailand
  • 2Department of Orthopedics, Bumrungrad International Hospital, Bangkok, 10110, Thailand

Abstract


Objectives
The purpose of the study is to assess the effectiveness of fracture liaison service (FLS) after 5-year implementation to close the secondary fracture care gap, ensuring that patients receive osteoporosis assessment, intervention, and treatment, therefore, reducing the fracture risk at Police General Hospital (PGH).
Methods
A prospective cohort study was conducted. We studied male and female, ≥ 50 years old who presented with a fragility hip fracture and participated in PGH’s FLS from April 1, 2014–March 31, 2019 (5 years implementation). The sample size was 353 patients, with 1-year follow-up. The data were compared with a previous study, before the commencement of the FLS.
Results
After 1-year follow up, the mortality rates were 5.95% and there were only 8 patients who had secondary fractures (2.93%), which showed a decrease of 30% from before FLS implementation. Post-injury bone mineral density (BMD) rates were increased from 28.33% to 85.84%, osteoporosis treatment rates were increased from 40.8% to 89.38%, and the time to surgery and hospitalization decreased from 7.9 to 5.0 days, and 23.2 to 19.6 days, respectively, all with statistical significance (P < 0.001). However, the 1-year mortality rates were not significant when compared to the previous study.
Conclusions
Patients with fragility hip fractures participating in FLS after 5-year implementation at PGH had significantly higher post-injury BMD and osteoporosis treatment rates and significantly shorter in time to surgery and hospitalization. This showed that secondary fracture rates were lower than before the project at 1-year of follow up.

Keyword

Fracture liaison service; Osteoporosis; Fragility hip fracture; Thailand
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