Table 1. Studies of FLS With Rates of Subsequent Fracture and Mortality as Outcomes.
| Source | Data Source | Intervention vs Control | ||||||
|---|---|---|---|---|---|---|---|---|
| Study Design | Patients, No. | Women, % | Mean Age, y | Absolute Fracture Rates, % | Rate of Subsequent Fracture Rate, HR (95% CI) | Mortality Rate, HR (95% CI) | ||
| Huntjens et al,17 2014 | ICD-9 fracture codes, national obituary database (date of death) | FLS vs non-FLS at different hospitals; prospective design | 1412 vs 1910 | 73 vs 70 | 71.1 vs 69.6 | 6.7 vs 6.8a | 1-y follow-up: 0.84 (0.64-1.10); 2-y follow-up: 0.44 (0.25-0.79) | At 2 y: 0.65 (0.53-0.79) |
| Nakayama et al,14 2016 | Emergency department (fracture codes) | FLS vs non-FLS at different hospitals; prospective design, intention-to-treat approach | 515 vs 416 (103 attended FLS) | 75 vs 74 | 76.6 vs 75.0 | 12.2 vs 16.8 | Any refracture, 3-y follow-up: 0.67 (0.47-0.95); major refracture, 3-y follow-up: 0.59 (0.39-0.90) | HR, 1.17b |
| Hawley et al,16 2016c | ICD-10 (hip fracture), Office for National Statistics (mortality) | Pre-FLS and post-FLS; before-after time series design | 33 152 | 78 | 82.7 | 4.2 | 1.03 (0.85-1.26) | At 30 d: 0.80 (0.71-0.91); at 1 y: 0.84 (0.77-0.93) |
| Axelsson et al,13 2016 | ICD-10, Swedish Population Register (death information) | Pre-FLS vs post-FLS; prospective design with historic controls | 2713 vs 2616 | 73 vs 74 | 76.1 vs 76.7 | 8.4 vs 8.3 | 0.95 (0.79-1.14) | 0.88 (0.76-1.03) |
| Huntjens et al,15 2011 | ICD-9, national obituary database | Pre-FLS vs post-FLS | 1920 vs 1335 | 75 vs 73 | 70.8 vs 71.9 | 9.9 vs 6.7 | 2-y follow-up: 0.65 (0.51-0.84) | At 2 y: 0.67 (0.55-0.81) |
| Van der Kallen et al,18 2014 | Diagnosis codes | FLS nonattendees vs FLS attendees; prospective design | 220 vs 214 | 77 vs 79 | 74 vs 72 | 18.6 vs 6.5 | 2-y follow-up: 18.6 vs 6.5d | NA |
| Astrand et al,19 2012 | Questionnaire | Pre-FLS vs post-FLS; historic controls | 306 vs 286 | 72 vs 76 | NA | 29 vs 18 | 6-y follow-up: 0.58 (0.39-0.89) | 17 vs 12a,d |
| Lih et al,20 2011 | Not mentioned | Nonattendees vs attendees; MTF service; prospective controlled observational design | 156 vs 246 | 75 vs 83 | 65.9 vs 66.4 | 19.7 vs 4.1 | Median 38-mo follow-up: 5.3 (2.71-11.6) | NA |
Abbreviations: FLS, fracture liaison service; HR, hazard ratio; ICD-9, International Classification of Diseases, Ninth Revision; ICD-10, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision; MTF, minimal trauma fracture; NA, not applicable.
a
Nonsignificant.
b
The 95% CI was not provided in the original article.
c
Because of the study design, data are shown for 1 group.
d
Absolute rates because HRs and 95% CIs were not calculated.