Taking care of inpatients with fragility hip fractures: the hip-padua osteosarcopenia (Hip-POS) fracture liaison service model
Gaetano Paride Arcidiacono, Chiara Ceolin, S. Sella, Valentina Camozzi, Alcide Bertocco, Marco Onofrio Torres, Maria Grazia Rodà, Michele Cannito, Antonio Berizzi, Giovanna Romanato, Andrea Venturin, Vito Cianci, A. Pizziol, Elisa Pala, Mariachiara Cerchiaro, Sandro Savino, Michele Tessarin, Paolo Simioni, Giuseppe Sergi, Pietro Ruggieri, Sandro Giannini, the Hip-POS working group, Carlotta Andaloro, Giulia Bano, Deris Gianni Boemo, Ester Bukli, Davide Cannavò, Alberta Cecchinato, Martina Dall’Agnol, Marina Rui, Mario Degan, Marta Dianin, Martin Diogo, Michela Ferrarese, Claudia Finamoni, Francesca Guidolin, Mario Rosario Lo Storto, Elena Marigo, Stefano Masiero, Caterina Mian, Maria Vittoria Nesoti, Mor Peleg Falb, Cristina Russo, Cristina Simonato, Giulia Termini, Hillary Veronese, Francesca Zanchetta, Chiara Ziliotto
Abstract
PURPOSE: Osteoporotic fragility fractures (FF), particularly those affecting the hip, represent a major clinical and socio-economic concern. These fractures can lead to various adverse outcomes, which may be exacerbated by the presence of sarcopenia, especially among older and frail patients. Early identification of patients with FF is crucial for implementing effective diagnostic and therapeutic strategies to prevent subsequent fractures and their associated consequences. METHODS: The Hip-POS program, implemented at Azienda Ospedale-Università Padova, is a Fracture Liaison Service (FLS) program to evaluate patients aged > 50 years old admitted with fragility hip fractures, involving an interdisciplinary team. After the identification of patients with hip fractures in the Emergency Department, a comprehensive evaluation is conducted to identify risk factors for further fractures, and to assess the main domains of multidimensional geriatric assessment, including muscle status. Patients are then prescribed with anti-fracture therapy, finally undergoing periodic follow-up visits. RESULTS: During the first five months, a total of 250 patients were evaluated (70.4% women, median age 85 years). Following assessment by the Hip-POS team, compared to pre-hospitalization, the proportion of patients not receiving antifracture therapy decreased significantly from 60 to 21%. The prescription rates of vitamin D and calcium increased markedly from 29.6% to 81%. CONCLUSIONS: We introduced the Hip-POS program for the care of older adults with hip fractures. We aspire that our model will represent a promising approach to enhancing post-fracture care by addressing the multifactorial nature of osteoporosis and its consequences, bridging the gap in secondary fracture prevention, and improving patient outcomes.