Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018
Rush Fracture Liaison Service for capturing "missed opportunities" to treat osteoporosis in patients with fragility fractures.
Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 18 citations in OpenAlex.
- Fracture liaison service evaluation during admission for fragility femur fracture increases rates of bone health intervention and outpatient follow-up.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- CT-Based Evaluation of Hounsfield Units-A Novel Screening Tool for Undiagnosed Osteoporosis in Patients with Fragility Fractures of the Pelvis.Journal of clinical medicine · 2025Article
- The Orthopedic Upper Extremity Surgeon's Role in the Diagnosis and Treatment of Osteoporosis: Making Use of Opportunistic Imaging.Journal of clinical medicine · 2024Review
- Impact of an Outpatient Fracture Liaison Service on Osteoporosis Evaluation Among Patients With Upper Extremity Fragility Fracture.Hand (New York, N.Y.) · 2024Article
- The sequential antifracturative treatment: a meta-analysis of randomized clinical trials.Therapeutic advances in musculoskeletal disease · 2024Article
- Future Fracture Risk in Upper Extremity Fracture and Non-Fracture Patients.Hand (New York, N.Y.) · 2023Article
- Treatment rates and healthcare costs of patients with fragility fracture by site of care: a real-world data analysis.Archives of osteoporosis · 2023Article
- Post-fracture care programs for prevention of subsequent fragility fractures: a literature assessment of current trends.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Review
- Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients.Current reviews in musculoskeletal medicine · 2019Review
- Under-Recognition of Fractures as Osteoporosis Indicators.Geriatrics (Basel, Switzerland) · 2019Article
- Review
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Authors and funding
4 authors at 2 institutions in 1 country.
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Abstract
In spite of being a public health problem of pandemic proportions, osteoporosis continues to be underdiagnosed and undertreated especially in older adults with fragility fractures. Confirmation of this hypothesis resulted in the development of a novel Fracture Liaison Service (Rush FLS). Results of the first 12 months of operation revealed that patients with confirmed fragility fracture do not have a timely diagnosis at fracture occurrence or treatment of their disease. The Rush FLS is an effective fracture liaison model.
introductionDetermining the prevalence of undiagnosed and untreated osteoporosis in fragility fracture patients, either admitted to an academic tertiary care center or treated and discharged from the center's emergency department to be followed in the endocrinology bone clinic, using an innovative, educational, low-cost, physician-run Fracture Liaison Service (FLS).
methodsAn automated alert was integrated into the electronic medical record at Rush University Medical Center (RUMC), triggered by historical and/or acute fracture(s) in patients 50 years or older, in patients that were either admitted to the hospital or in patients evaluated in the emergency department and discharged to be followed in the endocrinology bone clinic. We report the results of the first 12 months of operation in patients admitted to the hospital.
resultsFirst acute fragility fracture(s) were identified in 36% (80/223), only historical fragility fracture(s) in 28% (63/223) and both acute and historical fragility fracture(s) in 36% (80/223). The cumulative subgroup with historical fragility fractures with/without new fractures included 67% (96/143) without a previous diagnosis of osteoporosis. First acute fragility fracture group included 83.8% (67/80) without a previous diagnosis of osteoporosis. Rush FLS "captured missed opportunities" in 73.1% (163/223) of previously undiagnosed and 77.1% (172/223) of previously untreated osteoporosis patients. Dual-energy x-ray absorptiometry (DXA) prior to FLS consult was confirmed in 30% (67/223). Vitamin D deficiency (25-hydroxy vitamin D < 20 ng/ml) in 41.9% (78/186) including undetectable levels in 16.6% (31/186) and secondary hyperparathyroidism in 43.3% (78/180) were the most common laboratory confirmed secondary etiologies for bone loss.
conclusionsThis study reported undiagnosed, uninvestigated, and untreated osteoporosis in the majority of fragility fracture patients seen by the Rush FLS in the first 12 months of operation.
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