Investigation And Research On The Status Quo Of Diagnosis And Treatment Of Osteoporotic Fracture

PurposesWe explored the effects of the 2015 and 2017 guidelines on bone mineral density,diagnosis rate,and treatment rate in patients with osteoporotic fractures.MethodThis study used a case review form to investigate 2903 patients with osteoporotic fractures through the Dalian Central Hospital Information Management System.According to the location and type of fracture,osteoporotic fractures were first divided into four groups: hip,vertebral body,proximal humerus and distal radius.According to the release time of the two guidelines,the four groups of patients were divided into the first guide before the release of the guide(March 2014-December 2015)(Group A),between the first and second guides(2016year Group B),after the second guide was released from January 2017 to December 2018(Group C).Access to data collection includes: basic patient information(age,gender),bone mineral density examination,diagnostic information(diagnosed including osteoporosis or osteoporotic fracture),treatment during hospitalization and discharge of medication(including bone quality)Loose basic treatment and anti-osteoporosis treatment,the basic treatment includes: using calcium or vitamin D,anti-osteoporosis treatment includes: inhibition of bone resorption drugs,promotion of bone formation drugs,active vitamin D,vitamin K Class and some proprietary Chinese medicines,discharge summary has clear recommendations for anti-osteoporosis.ResultAge: The osteoporotic hip,vertebral body,proximal humerus,and distal humerus group were statistically significant before and after the publication of the two guidelines(P<0.05),and the age of the clinic showed an increasing trend.In terms of sex ratio,the osteoporotic hip,vertebral body,proximal humerus,and distal humerus group were not statistically different before and after the publication of the two guidelines,but the proportion of women was higher.Bone mineral density examination: Only the osteoporotic vertebral fracture group was statistically significant before and after the publication of the two guidelines(P<0.05).There were no significant differences in osteoporotic hip,proximal humerus,and distal radius fractures.In the discharge summary recommendation: the osteoporotic hip and vertebral fracture group were statistically significant before and after the promulgation of the two guidelines(P=0.008,P=0.026).In the basic treatment: osteoporotic hip,vertebral body,and proximal humeral fracture group were statistically significant before and after the promulgation of the two guidelines(P=0.013,P=0.030,P=0.005).In the treatment of osteoporosis: the osteoporotic hip,vertebral body,proximal humerus,and distal humerus group were not statistically different before and after the promulgation of the two guidelines,but the anti-osteoporosis treatment rate was relatively Higher.ConclusionThe two guidelines have improved the diagnostic rate and basic treatment rate for osteoporotic hip and vertebral fractures during hospitalization.There is still much room for improvement in the examination,diagnosis and anti-osteoporosis treatment of osteoporotic fractures.Clinical first-line physicians should follow the guidelines published in China as far as possible in clinical practice to make the diagnosis and treatment of osteoporotic fractures more reasonable and standardized,so that patients can get a better prognosis.