整形外科 醫師의 認識이 股關節 周圍骨折 患者의 骨多孔症에 미치는 影響

Abstract

Purpose : Under treatment of osteoporosis following hip fracture has been a global issue. In 2005 the authors conducted a retrospective cohort study in Jeju Island where it was found that hip fracture occurred in 174 patients, who were over 50 years of age. Among these 174 patients, 35 patients (20.1%) had their bone mineral density tested for and 27 patients (15.5%) received osteoporosis medication. The purpose of this study was to determine whether orthopedic surgeon intervention program would improve osteoporosis management after hip fracture. Materials and Methods : A prospective cohort study was performed with the use of patient databases at one university medical center and seven university-affiliated community hospitals. Patients over 50 years of age who were admitted for hip fractures at these eight centers during 2007 were enrolled and their hospital record reviewed. During this period, orthopedic surgeons who worked at these hospitals were provided with two education sessions with posters and brochures. Patients were interviewed with evaluation questionnaire for their awareness and barrier of osteoporosis treatment after six months discharge and were followed-up for at least a year. Results : There were 208 hip fractures (34 in man and 174 in woman) in 2007. Thirty-eight patients (18.3%) died during the follow-up period. DXA was performed on 94 patients (45.2%) and 67 patients (32.2%) received a prescription at the time of discharge. According to the patient interview questionnaire, the most common barrier to the treatment of osteoporosis following hip fracture was patients' reluctance to treat osteoporosis. Conclusion : Osteoporosis detection and medication rate after hip fracture increased two fold after the orthopedic surgeon intervention program. Although osteoporosis treatment rate is still insufficient, it will continue to increase in the future with continued educational efforts.