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Secondary screening for osteoporosis in patients admitted with minimal‐trauma fracture to a major teaching hospital
Author(s) -
Wong P. K. K.,
Spencer D. G.,
McElduff P.,
Manolios N.,
Larcos G.,
Howe G. B.
Publication year - 2003
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1046/j.1445-5994.2003.00468.x
Subject(s) - medicine , osteoporosis , vitamin d and neurology , pediatrics , prolactin , gastroenterology , hormone
Aims: The aim of the present study was to determine: (i) the prevalence of the investigation and treatment of osteoporosis in patients admitted to hospital with a minimal‐trauma fracture, (ii) the prevalence of osteoporosis using bone mineral density assessment by dual X‐ray absorptiometry (DEXA) in such patients and (iii) a clinical pathway for the management of osteoporosis in such patients. Methods: A cross‐sectional study was undertaken involving all patients admitted with a fracture to Westmead Hospital, Sydney, Australia, between January 1999 and June 2000 ( n = 327). Of these, 264 were excluded because of: (i) the fracture following significant trauma ( n = 83), (ii) unavailability of medical records for review ( n = 38), (iii) nursing home status ( n = 37), (iv) previous malignancy ( n = 18), (v) deceased ( n = 11), (vi) recent osteoporosis screening and/or treatment ( n = 18), (vii) refusal to participate ( n = 37), (viii) uncontactable ( n = 16) and (ix) inadequate English ( n = 6). The remaining 63 patients underwent DEXA assessment and the following laboratory investigations: (i) liver function tests, (ii) urea, (iii) electrolytes, (iv) calcium, (v) phosphate, (vi) full blood count, (v) 25‐hydroxyvitamin D level and (vi) thyroid‐function tests. In men, levels of serum free testosterone, luteinizing hormone, follicle‐stimulating hormone and prolactin were also obtained. Results: Of the 63 study participants, 87% of the 47 women were either osteoporotic (T <−2.5) or osteopenic (−2.5