Health Outcomes in Fragility Fractures in the Spanish Registry of Osteoporotic Fractures According to the FLS Care Model
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Fracture Liaison Services (FLS) are the gold standard for secondary fracture prevention, but their characteristics vary depending on the care model. This study describes the differences between Orthogeriatric (FLS-ORT) and Bone Metabolism (FLS-MET) models in Spain, based on data from the national osteoporotic fracture registry. METHODS: We conducted a retrospective, multicenter cohort study including 8,962 patients aged ≥50 years with fragility fractures from 25 active FLS in Spain (2019-2023). Patients were classified based on the care model: FLS-ORT (n = 3,695) or FLS-MET (n = 5,267). Baseline characteristics, fracture types, treatment initiation, adherence, and 12-month outcomes were compared. RESULTS: FLS-ORT patients were older (85 vs. 78 years, p <0.001), had more comorbidities, and a higher risk of falls. Hip fractures were predominant in FLS-ORT (75.8%), while vertebral fractures were more frequent in FLS-MET (p <0.001). Time from fracture to FLS assessment was shorter in FLS-ORT (0.1 vs. 1.6 months, p <0.001). At 12 months, fracture recurrence was higher in FLS-ORT (7.7 vs. 5.5 per 100 patient-years), and mortality was significantly greater (p <0.0001). However, osteoporosis treatment initiation (84.6%) and adherence (85.2%) were comparable across models. CONCLUSIONS: FLS are the gold standard for secondary fracture prevention. Both FLS care models (FLS-ORT and FLS-MET) were effective in reducing the risk of new fractures in patients and minimizing the impact on the quality of life of patients who suffer a fragility fracture. Future integration into a unified model assessing all fractures is anticipated.
Source: Archives of Medical Research
Authors: Leonor Cuadra-LLopart, Samantha Santana Zorrilla, Daniel Martínez-Laguna, Mercè Giner, Rafael Izquierdo Aviñó, Ma Jose Montoya-Garcia, Diana Ovejero Crespo, Manuel Mesa Ramos, Sonia Castro Oreiro, Laura Fernández Sénder, Leticia Lojo-Oliveira, Carmen Gomez-Vaquero, Christian Alvarado Escobar, Ma Jesús Montesa, Teresa Pareja Sierra, Cristina Campos Fernández, Jose Cancio-Trujillo, Sonia Fuentes, Ma Jose Marassi-Campos, Guillermo Martinez Diaz-Guerra, Jesús Mora-Fernández
Institutions: Universitat Internacional de Catalunya, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Universidad de Sevilla, Hospital Universitario Virgen Macarena, Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Hospital del Mar Research Institute, Hospital Universitari Joan XXIII de Tarragona, Hospital Sant Pau i Santa Tecla, Hospital Universitario Infanta Leonor, Bellvitge University Hospital, Hospital d'Igualada, Hospital Universitario Nuestra Señora de Candelaria, Hospital Universitario de Guadalajara, Hospital General Universitario De Valencia, Universitat Pompeu Fabra, Maresme Health Consortium, TecnoCampus, Universidad de Las Palmas de Gran Canaria, Hospital Universitario de Gran Canaria Doctor Negrín, Hospital Doctor José Molina Orosa, Universidad Complutense de Madrid, Research Institute Hospital 12 de Octubre, Hospital Universitario 12 De Octubre, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,360
Funders: Amgen, UCB, Gedeon Richter, UCB Pharma, Gedeon Richter
OpenAlex ID: W4414380289