| Objective : To study the characteristics,diagnosis,treatment and secondary prevention status of elderly osteoporotic fractures by investigating and analyzing the clinical data of elderly osteoporotic fractures in two third Grade A hospitals in Dalian and Shenyang of Liaoning province,and then provide the basis of the diagnosis,treatment and prevention of elderly osteoporotic fractures in the region.Methods:The clinical data of 406 cases of osteoporotic fractures over 60 years old in a third Grade A hospital in Dalian and 365 cases in Shenyang from January 2015 to December 2015 were collected,and then statistically analyzed the basic information(age,gender,diastolic blood pressure,systolic blood pressure,body weight,height,BMI),clinical data(serum alkaline phosphatase,serum albumin,creatinine,endogenous creatinine clearance rate,fasting blood glucose,calcium,phosphorus,complications,fractured position,fractured number,fractured season,imageological examination,surgery or not),diagnosis and anti-osteoporosis therapy of them.Results:1.Among the total number of fractures,patients with osteoporotic fractures over 60 years old in a third Grade A hospital in Dalian accounted for 37.52%(406/1082).There were 291 female cases,whose average age was(73.84±8.85)years old,serum albumin was(39.49±4.99)g/L,fasting blood glucose was(5.96±2.61)mmol/L.There were 115 male cases,whose average age was(74.92±9.79)years old,serum albumin was(38.90±4.92)g/L,fasting blood glucose was(6.02±1.75)mmol/L.Additionally,among the total number of fractures,patients with osteoporotic fractures over 60 years old in a third Grade A hospital in Shenyang accounted for 47.10%(365/775).There were 252 female cases,whose average age was(74.50±8.43)years old,serum albumin was(39.37±4.17)g/L,fasting blood glucose was(5.98±1.75)mmol/L.There were 113 male cases,whose average age was(71.65±8.20)years old,serum albumin was(38.06±3.99)g/L,fasting blood glucose was(5.85±1.49)mmol/L.The proportion of osteoporotic fractures in the elderly was high of the total number of fractures,especially in older women.The serum albumin of them was generally lower and the fasting blood glucose was a little higher than normal.2.The common complications of the elderly patients with osteoporotic fractures in the two hospitals both were hypertension,lacunar infarction,coronary heart disease and diabetes.Besides,the coexistence of multiple diseases was so common.There had 96(23.65%)cases with two diseases and 82(20.20%)cases with three or more diseases in Dalian hospital,while the numbers in Shenyang hospital respectively were 99(27.12%)cases and 67(18.36%)cases.3.The predilection sites of the elderly osteoporotic fractures in the two hospitals both were followed by the hip,spine,ulnar radius distal and proximal humerus.There were 327(80.54%)cases of single-site fracture,79(19.46%)cases of multiple-site fractures and 54(13.30%)cases of secondary fractures in Dalian hospital,while the numbers in Shenyang hospital respectively were 310(84.93%)cases,55(15.07%)cases and 30(8.22%)cases.4.The incidence rates of the elderly osteoporotic fractures in winter and spring were 52.96% in Dalian hospital and 51.23% in Shenyang hospital.They were higher than the percentage of summer and autumn,which were 47.04% in Dalian hospital and 48.77% in Shenyang hospital.5.There were 50(12.32%)cases who had the diagnosis of osteoporosis in Dalian hospital and 91(22.41%)cases who were given the anti-osteoporosis therapy during hospitalization,in which 54(13.30%)cases with one type of anti-osteoporosis medicine,27(6.65%)cases with two types and 10(2.46%)cases with three types.There were also 83(20.45%)cases who were given the anti-osteoporosis therapy of discharged medical orders,in which 57(14.04%)cases with one type of anti-osteoporosis medicine,20(4.93%)cases with two types and 6(1.48%)cases with three types.Only 3(0.74%)cases had the diagnosis of osteoporosis and were given anti-osteoporosis therapy of hospitalization and discharge medical orders.Additionally,There were 57(15.62%)cases had the diagnosis of osteoporosis in Shenyang hospital and 99(27.12%)cases who were given the anti-osteoporosis therapy during hospitalization,in which 60(16.44%)cases with one type of anti-osteoporosis medicine,32(8.76%)cases with two types and 7(1.92%)cases with three types.There were also 62(16.98%)cases who were given the anti-osteoporosis therapy of discharged medical orders,in which 46(12.60%)cases with one type of anti-osteoporosis medicine,12(3.29%)cases with two types and 4(1.09%)cases with three types.Only 2(0.55%)cases had the diagnosis of osteoporosis and were given anti-osteoporosis therapy of hospitalization and discharge medical orders.Therefore,the rates of osteoporotic diagnosis,standardized anti-osteoporosis therapy and combined medicine were relatively low.Conclusion:1.The elderly osteoporotic fractures in the region of Liaoning is characterized by the distribution in the number of patients,gender,serum albumin,fasting blood glucose,fractured site,fractured number,fractured season and complications.2.The attention of osteoporosis in the elderly is still insufficient in the region,and the situation of osteoporotic diagnosis,anti-osteoporosis therapy and the secondary prevention is not optimistic.Education should be strengthened in the publicity and the rates of osteoporotic diagnosis and anti-osteoporosis therapy should be improved.Only in this way,can we slow the progression of osteoporosis in the elderly and prevent the occurrence of brittle fractures. |
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