| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 983.83 KB | Adobe PDF |
Abstract(s)
Introdução: A Osteoporose é uma das doenças mais comuns em todo o mundo e
espera-se que aumente de prevalência nos próximos anos com o envelhecimento
populacional. O seu maior risco são fraturas de fragilidade que resultam em significativa
morbilidade e mortalidade. Essas fraturas resultam na maioria dos casos de quedas. O
risco de queda também aumenta com a idade. Múltiplas comorbilidades e fármacos
contribuem tanto para diminuição da massa óssea como para quedas.
Neste estudo avaliou-se sistematicamente o risco de fratura associado a comorbilidades
e medicação crónica em doentes seguidos num centro de ligação de fraturas entre 1 de
janeiro de 2017 e 31 de agosto de 2020.
Métodos: Estudo observacional, transversal e retrospetivo de um centro de ligação de
fraturas. As comorbilidades foram classificados de acordo com o International
Statistical Classification of Diseases and Related Health Problems – 10 e a medicação
crónica de acordo com a classificação Anatomic Therapeutic Chemical e foram
categorizados como associados a diminuição da massa óssea ou a risco de queda.
Resultados: Dos 189 doentes referenciados ao centro de ligação de fraturas, foram
incluídos 154 doentes. 89% eram do sexo feminino, com uma média de idade de 77,4 ±
10,0 anos, com 81,8% com =70 anos. 91,6% apresentam pelo menos um fator de risco
ósseo, 92,2% pelo menos um fator de risco relacionado com queda e apenas um doente
sem qualquer fator de risco (0,6%). 87% tinham pelo menos uma comorbilidade
relacionada com queda e 77% estavam medicados com pelo menos um fármaco
potenciador de quedas. A média do total de fatores de risco identificados é 6.13 ± 3,4. Os
doentes com = 2 fraturas apresentam mais comorbilidades relacionadas com a queda (pvalue = 0,029).
Discussão e Conclusão: Identificaram-se múltiplos fatores de risco, com
sobreposições heterogéneas e uma infinidade de combinações. Isto aponta para a
necessidade de uma avaliação integrada de todos os fatores de risco relacionados com
queda, além da avaliação de fatores de risco ósseo num centro de ligação de fraturas.
Reforça ainda a importância de incluir a avaliação sistemática do risco de quedas nesta
população, e subsequente implementação de estratégias de prevenção de quedas.
Introduction: Osteoporosis is one of the most common diseases worldwide and is expected to increase in prevalence in the coming years with population aging. It can lead to fragility fractures with significant morbidity and mortality. These fractures result in most cases of falls. The risk of falling also increases with age. Multiple comorbidities and drugs contribute both to a decrease in bone mass and to a higher risk of falls. In this study, the risk of fracture associated with both comorbidities and chronic medication was systematically assessed in patients followed at a fracture liaison service between 1 January 2017 and 31 August 2020 Methods: Observational, cross-sectional and retrospective study of consecutive patients at a fracture liaison service. Comorbidities were classified according to the International Statistical Classification of Diseases and Related Health Problems - 10 and chronic medication according to the Anatomic Therapeutic Chemical classification and were categorized as associated with decreased bone mass or risk of falling. Results: Of the 189 patients referred to the fracture liaison service, 154 patients were included. 89% were female, with an average age of 77.4 ± 10.0 years with 81.8% with =70 years. 91.6% have at least one bone risk factor, 92.2% at least one fall risk factor and only one patient without any risk factor (0.6%). 87% had at least one fall-related comorbidity and 77% were medicated with at least one fall-enhancing drug. 6.13 ± 3.4 risk factors were identified in average. Patients with = 2 fractures have more fall-related comorbidities (p-value = 0.029). Discussion and Conclusion: Multiple risk factors were identified, with heterogeneous overlaps and a multitude of combinations. This points to the need for an integrated assessment of all risk factors related to falls, in addition to bone risk factors assessment in a fracture liaison service. It also reinforces the importance of including systematic assessment of fall risk in this population, and the subsequent implementation of fall prevention strategies.
Introduction: Osteoporosis is one of the most common diseases worldwide and is expected to increase in prevalence in the coming years with population aging. It can lead to fragility fractures with significant morbidity and mortality. These fractures result in most cases of falls. The risk of falling also increases with age. Multiple comorbidities and drugs contribute both to a decrease in bone mass and to a higher risk of falls. In this study, the risk of fracture associated with both comorbidities and chronic medication was systematically assessed in patients followed at a fracture liaison service between 1 January 2017 and 31 August 2020 Methods: Observational, cross-sectional and retrospective study of consecutive patients at a fracture liaison service. Comorbidities were classified according to the International Statistical Classification of Diseases and Related Health Problems - 10 and chronic medication according to the Anatomic Therapeutic Chemical classification and were categorized as associated with decreased bone mass or risk of falling. Results: Of the 189 patients referred to the fracture liaison service, 154 patients were included. 89% were female, with an average age of 77.4 ± 10.0 years with 81.8% with =70 years. 91.6% have at least one bone risk factor, 92.2% at least one fall risk factor and only one patient without any risk factor (0.6%). 87% had at least one fall-related comorbidity and 77% were medicated with at least one fall-enhancing drug. 6.13 ± 3.4 risk factors were identified in average. Patients with = 2 fractures have more fall-related comorbidities (p-value = 0.029). Discussion and Conclusion: Multiple risk factors were identified, with heterogeneous overlaps and a multitude of combinations. This points to the need for an integrated assessment of all risk factors related to falls, in addition to bone risk factors assessment in a fracture liaison service. It also reinforces the importance of including systematic assessment of fall risk in this population, and the subsequent implementation of fall prevention strategies.
Description
Keywords
Avaliação de Risco de Fraturas Comorbilidades Medicação Osteoporose Prevenção de Fraturas