Fracture Liaison Service Increases Potent Anti-osteoporotic Treatment Initiation and Reduces Mortality and Recurrent Hip Fractures among Patients Admitted for Rehabilitation following Hip Fracture - Endo Annual 2022 The 50th Annual Meeting of The Israel Endocrine Society

Hadar Alkobi Wiess ¹ Adi Goldbart ² Vitali Medvedovsky ^3,6 Dayana Cohen ³ Lior Baraf ^3,6 Tamar Eshkoli ^3,4,6 Vera Polischuk ⁵ Poliana Shamgar ² Lihi Mazuz ² Yan Press ^5,6 Merav Fraenkel ^3,6 Uri Yoel ^3,6

¹Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev
²Clinical Research Center, Soroka University Medical Center
³Endocrinology, Soroka University medical center
⁴Obstetrics and Gynecology, Soroka University Medical Center
⁵Geriatrics, Soroka University Medical Center
⁶Faculty of Health Science, Ben-Gurion University of the Negev

Background:
Osteoporosis treatment rates following hip fractures (HF) are low. Fracture liaison services (FLS) increase rates of effective anti-osteoporosis treatment and potentially decrease mortality.

Aim:
To assess the impact of in hospital FLS on re-fracture and mortality rate.

Methods:
This retrospective study included patients over 65 years admitted to Soroka University Medical Center (SUMC) with HF, who were operated and transferred for rehabilitation at the Geriatrics department in 2 equal time periods: before and after the implementation of SUMC FLS. Data were captured from patient`s electronic medical charts including demographics, medical history, drug purchase and laboratory data before and after HF.

Results:
319 and 667 patients fulfilled study criteria for the ‘pre-FLS’ and ‘FLS’ cohorts respectively. Baseline characteristics of both cohorts were similar excluding lower eGFR and higher treatment rates of PPI and steroid in the ‘FLS’ cohort. Rates of endocrine consultation (93.4% vs 3.4% p<001), performance of DXA-BMD scan (42.3% vs. 7.5% p<0.001), and parenteral anti-osteoporosis treatment (65.2% vs 3.1% p<0.001) were higher in the ‘FLS’ cohort. In a multivariable cox regression, adjusted for age, Charlson Comorbidity Index, and Functional Independence Measure (FIM) score, the FLS implementation decreased the composite outcome of recurrent HF and mortality in patients under, but not above the age of 80, (OR 0.55; CI 0.36-0.83, p=0.004).

Conclusions:
In hospital FLS Implementation increased rates of endocrine consultation, performance of DXA-BMD scan and parenteral treatment for osteoporosis of patients admitted for rehibilitation following HF. FLS decreased mortality and second HF rates under the age of 80.