| Objective To analyze the clinical medical records of inpatients in the hospital with hip or vertebral fragility fractures,we can understand the treatment status,the deficiencies in the relevant diagnosis and the treatment process with this kind of fractures in this hospital.And at the same time explored the economic burden related to fragility fractures and its influencing factors,we can provide certain help for the clinical diagnosis and treatment of fragility fractures in this area.Methods Collected the medical records of 861 patients over the age of 50 who were hospitalized at the general hospital of Ningxia medical university from August 2017 to January 2020 due to vertebral or hip fragility fractures,and part of the follow-up data obtained by effective telephone follow-up for 1 year after discharge.The collection included general condition(gender,age),assessment of fragility fractures during hospitalization(bone mineral density testing,calcium and 25-hydroxy vitamin D testing,N-terminal pro-collagen of type l collagen testing,and whether there was osteoporosis diagnosis)and the main treatment methods of hospitalization,the use of osteoporosis drugs in the hospital,the treatment plan of osteoporosis drugs ordered by the discharged doctor,and the treatment of osteoporosis-related drugs before the fracture of the patient and within 1 year after discharge from the hospital.Finally,the relevant statistical analysis was carried out.Collected the medical records of 754 patients over the age of 50 who were hospitalized at the general hospital of Ningxia medical university from January2018 to December 2019 due to hip or vertebral fragility fractures,and counted the patient’s gender,age,previous fracture history,fracture site,treatment methods,chronic comorbidities,fracture complications,hospitalization days and hospitalization expenses.At the same time,the influence of age,gender,previous fracture history,complications,number of chronic comorbidities,fracture site,and treatment methods on the length of hospitalization and hospitalization expenses were discussed.Results 1.The evaluation of fragility fractures during hospitalization: the total detection rate of Ca2+ for fragility fractures was 100%,the total detection rate of 25-hydroxy vitamin D was 6.4%,and the total detection rate of N-terminal pro-collagen of type l collagen was 4.4%.The total detection rate of bone mineral density was 18.7%.The total diagnosis rate of osteoporosis in hospital was 50.2%.The total detection rate of 25-hydroxy vitamin D,N-terminal pro-collagen of type l collagen,bone mineral density and the diagnosis rate of osteoporosis with hip fragility fractures were lower than those of vertebral fragility fractures(P<0.05).2.The treatment of fragility fractures: the surgical treatment rate of hip fragility fractures was 80.5%,and that of vertebral fragility fractures was 71.4%.During hospitalization,the rate of osteoporosis-related drug treatment for patients with fragility fractures was 55.7%,and the rate of osteoporosis-related drug treatment for patients with fragility fractures as reflected in the discharge doctor’s order was 22.6%.Obtained effective follow-up of 682 patients with osteoporosis-related drug treatment rate before fracture was 10.6%,and osteoporosis-related drug treatment rate within 1 year after discharge from hospital was 25.9%.The treatment rate of osteoporosis-related drugs in patients with hip fragility fractures during hospitalization and discharge from the hospital was lower than the vertebral fragility fractures(P<0.05).Osteoporosis-related drug treatment rates for hip fragility fractures and vertebral fragility fractures within 1year after discharge from the hospital were both higher than before the fractures(P<0.05).3.Fragility fractures and the disease burden: Single and multiple factor analysis of hospital stays suggested that there were complications,the number of chronic comorbidities ≥ 3,hip fragility fractures and surgical treatment will prolong the hospital stay(P<0.05).Both single and multiple factor analysis of hospitalization expenses indicated that complications,hip fragility fractures and surgical treatment would increase the hospitalization expenses of patients(P<0.05).Conclusion 1.Patients with fragility fractures did not receive adequate treatment before the fracture,during hospitalization,and within 1 year after discharge.The treatment rate of osteoporosis-related drugs within 1 year after discharge increased than before the fractures,but the diagnosis and treatment situation was still not optimistic.2.The diagnosis rate and drug treatment rate of osteoporosis in patients with hip fractures were far lower than those of vertebral fractures.Clinicians paid far less attention to osteoporosis in patients with hip fractures than those of vertebral fractures.3.In terms of the disease burden,complications,hip fragility fractures and surgical treatment in patients with osteoporosis fractures were the important reasons for prolonging the hospital stay and increasing hospitalization costs.Although the increase in the number of chronic comorbidities could extend the length of the stay,it did not necessarily increase the hospitalization costs accordingly,and it may be related to non-surgical treatment for this part of the population due to poor general conditions.4.Preventing complications could effectively shorten the stays and reduce the economic burden of the fragility fractures. |
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