Endocrinology · General Practice · 4 h ago
Fracture liaison service linked to fewer refractures at three years
In a retrospective cohort study of 406 adults aged 50 years or older with minimal-trauma fractures, Westmead Hospital patients who attended a fracture liaison service had fewer refractures by three years than invited patients who did not attend. No significant difference was observed at one year; the non-randomized design limits causal conclusions.
- Three-year refracture rates were 10.4% with FLS and 23.6% in controls.
- One-year rates did not differ significantly.
- FLS attendance was associated with lower refracture hazard after year one.
- Retrospective, non-randomized design limits causal interpretation.
Researchers retrospectively compared refracture outcomes among 406 people aged 50 years or older who presented to Westmead Hospital in Western Sydney with a minimal-trauma fracture between 2019 and 2022. The hospital’s multidisciplinary, Type A fracture liaison service (FLS) used an automated tool to identify fracture cases. Of the cohort, 279 attended the FLS and 127 invited patients who did not attend formed the comparison group. Refractures were identified using the same automated system, with a latency period of more than 90 days after the initial fracture.
At one year, refracture rates were 4.3% among FLS attendees and 5.5% among controls (p=0.61). At three years, rates were 10.4% and 23.6%, respectively (p<0.001). FLS attendance was associated with a lower refracture hazard between one and three years (HR 0.309, p<0.0005). FLS participants were more likely to have had a fracture in the preceding three years at baseline (10.0% vs 1.6%).
The findings support the potential value of coordinated secondary fracture prevention, including automated case-finding, in this setting. However, this was a retrospective, non-randomized comparison; attendance may reflect differences between groups, and the results do not establish that FLS participation caused the reduction.
In practice
For adults aged 50 years or older with a minimal-trauma fracture, attendance at this multidisciplinary fracture liaison service was associated with fewer refractures at three years, while the one-year difference was not significant. The findings support the potential value of organized secondary fracture prevention and case-finding, but they do not establish a causal effect or prove that this result will generalize to other services. The retrospective, non-randomized comparison may be affected by differences between attendees and non-attendees.
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Osteoporosis International: Preventing re-fractures in Western Sydney: three-year outcomes of an Australian fracture liaison service utilising a novel automated fracture-finding Tool ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.