Table 2.
Characteristics of patients with vertebral fracture managed by the Fracture Liaison Service by route of identification. Results are expressed as n (%) and mean (SD) unless expressly indicated
| All patients N = 570 | Emergency registry N = 198 | Referral to metabolic clinic N = 303 | Vertebral fracture assessment N = 69 | p | |
|---|---|---|---|---|---|
| Age, years | 73.6 (9.7) | 75.5 (9.4) | 72.6 (9.9) | 72.4 (8.8) | 0.003 |
| Sex, women | 480 (84.2) | 156 (78.7) | 261 (86.1) | 63 (91.3) | 0.020 |
| Time from sentinel fracture to visit (weeks) | |||||
| Mean | 17 (11) | 13 (8) | 20 (12) | 13 (8) | 0.02 |
| Median (IQR) | 13 (8–20) | 12 (8–16) | 13 (8–28) | 12 (8–16) | |
| < 12 weeks | 214 (37) | 83 (42) | 101 (33) | 30 (43) | 0.08 |
| Vertebral fractures | |||||
| Number of fractured vertebrae | |||||
| mean | 2.0 (1.6) | 1.76 (1.4) | 2.35 (1.8) | 1.22 (0.5) | |
| median (IQR) | 1 (1–2) | 1 (1–2) | 2 (1–3) | 1 (1–1) | 0.000 |
| range | 1–12 | 1–10 | 1–12 | 1–4 | |
| Only grade 1 fractures | 24 (4.2) | 3 (1.5) | 20 (6.6) | * | 0.007 |
| Two or more fractured vertebrae** | 259 (45.7) | 78 (39.3) | 169 (56.1) | 12 (17.4) | 0.000 |
| At least one grade 3 fracture*** | 274 (48.8) | 124 (63.9) | 141 (47.3) | 9 (12.0) | 0.000 |
| Risk factors for fracture | |||||
| Previous fracture | 155 (27.2) | 51 (25.8) | 89 (29.3) | 15 (20.0) | 0.362 |
| Parental hip fracture | 51 (8.9) | 20 (10.1) | 25 (8.2) | 6 (8.0) | 0.775 |
| Active smoking | 67 (11.7) | 21 (10.6) | 34 (11.2) | 12 (16.0) | 0.294 |
| Glucocorticoid use | 51 (8.9) | 9 (4.5) | 40 (13.2) | 2 (2.7) | 0.001 |
| Rheumatoid arthritis | 22 (3.8) | 5 (2.5) | 17 (5.6) | 0 | 0.045 |
| Secondary osteoporosis | 86 (15.0) | 37 (18.6) | 36 (11.8) | 13 (17.3) | 0.075 |
| Excessive alcohol intake† | 21 (3.6) | 9 (4.5) | 10 (3.3) | 2 (2.7) | 0.712 |
| Body mass index, kg/m2 | 27.5 (5.0) | 28.5 (4.7) | 26.2 (5.3) | 28.7 (5.1) | 0.000 |
| FRAX major osteoporotic fracture | 12.7 (8.6) | 13.3 (9.6) | 13.0 (11.0) | 10.8 (7.9) | 0.156 |
| FRAX hip fracture | 5.6 (6.6) | 6.0 (7.9) | 5.9 (4.0) | 4.3 (6.6) | 0.231 |
| Number of falls in the last year | |||||
| mean | 1.1 (1.0) | 1.2 (0.9) | 0.9 (1.0) | 1.5 (1.0) | |
| median (IQR) | 1.0 (1–1) | 1.0 (1–1) | 1.0 (0–1) | 1.0 (1–1) | 0.000 |
| range | 0–4 | 0–4 | 0–4 | 1–5 | |
| Bone densitometry # | |||||
| Normal | 46 (8.6) | 18 (10.0) | 18 (6.3) | 10 (13.3) | 0.000 |
| Osteopenia | 175 (32.8) | 69 (38.5) | 75 (26.3) | 31 (41.3) | |
| Osteoporosis | 312 (58.5) | 92 (51.3) | 192 (67.3) | 28 (37.3) | |
| Lumbar spine T-score | -2.29 (2.0) | -2.0 (1.7) | -2.5 (2.3) | -1.4 (1.5) | 0.000 |
| Femoral hip T-score | -1.91 (1.0) | -1.8 (1.2) | -2.0 (1.0) | -1.5 (0.9) | 0.003 |
| Osteoporosis medication& | |||||
| Previous treatment | 124 (21.8) | 35 (17.6) | 80 (28.0) | 9 (12.0) | 0.012 |
| Treatment initiation within 6 months of the visit | 474 (83.1) | 161 (81.3) | 265 (87.4) | 48 (69.5) | 0.001 |
*Only grade 2 and 3 fractures were included in vertebral fracture assessment with densitometry
**Available in 567 patients
***Available in 561 patients
†more than 3 units/day
#Available in 533 patients
&Bisphosphonate, denosumab, a selective estrogen receptor modulator, or teriparatide