EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures

被引：141

作者：

Lems, W. F. ^{[1
]}

Dreinhofer, K. E. ^{[2
]}

Bischoff-Ferrari, H. ^{[3
,4
]}

Blauth, M. ^{[5
]}

Czerwinski, E. ^{[6
]}

da Silva, J. A. P. ^{[7
,8
]}

Herrera, A. ^{[9
]}

Hoffmeyer, P. ^{[10
]}

Kvien, T. ^{[11
]}

Maalouf, G. ^{[12
]}

Marsh, D. ^{[13
]}

Puget, J. ^{[14
]}

Puhl, W. ^{[15
]}

Poor, G. ^{[16
]}

Rasch, L. ^{[1
]}

Roux, C. ^{[17
]}

Schuler, S. ^{[2
]}

Seriolo, B. ^{[18
]}

Tarantino, U. ^{[19
]}

van Geel, T. ^{[20
]}

Woolf, A. ^{[21
]}

Wyers, C. ^{[22
,23
]}

Geusens, P. ^{[24
,25
]}

机构：

[1] Vrije Univ Amsterdam Med Ctr, Amsterdam Rheumatol & Immunol Ctr, Dept Rheumatol, Amsterdam, Netherlands

[2] Charite, Ctr Musculoskeletal Surg CMSC, Dept Orthoped & Traumatol, Med Pk Berlin Humboldtm~hle, Berlin, Germany

[3] Univ Hosp, Dept Geriatr & Aging Res, Zurich, Switzerland

[4] Univ Zurich, Zurich, Switzerland

[5] Med Univ Innsbruck, Dept Trauma Surg, Innsbruck, Austria

[6] Jagiellonian Univ, Krakow Med Ctr, Fac Hlth & Sci, Dept Bone & Joint Dis, Krakow, Poland

[7] Univ Coimbra, Fac Med, Dept Rheumatol, Coimbra, Portugal

[8] Univ Coimbra, Cent Hosp, Coimbra, Portugal

[9] Univ Zaragoza, Dept Surg, Zaragoza, Spain

[10] Univ Geneva, Fac Med, Dept Surg, Div Orthopaed, Geneva, Switzerland

[11] Diakonhjemmet Hosp, Dept Rheumatol, Oslo, Norway

[12] Bellevue Univ Med Ctr, St Joseph Univ, Fac Med, Beirut, Lebanon

[13] UCL, London, England

[14] Ctr Hospitalier Univ Toulouse, Hop Rangueil, Dept Orthopaed Surg, Toulouse, France

[15] Univ Ulm, Ulm, Germany

[16] Semmelweis Univ, Natl Inst Rheumatol & Physiotherapy, Dept Internal Med 3, Rheumatol Chair, Budapest, Hungary

[17] Paris Descartes Univ, Cochin Hosp, INSERM 1153, Dept Rheumatol, Paris, France

[18] Univ Genoa, Dept Internal Med, Div Clin Rheumatol, Res Lab & Acad, Genoa, Italy

[19] Univ Roma Tor Vergata, Dept Orthopaed & Traumatol, Rome, Italy

[20] Maastricht Univ, CAPHRI Sch Publ Hlth & Primary Care, Dept Family Med, Maastricht, Netherlands

[21] Royal Cornwall Hosp, Knowledge Spa, Bone & Joint Res Grp, Truro, England

[22] Maastricht Univ, NUTRIM Sch Nutr & Translat Res Metab, Dept Internal Med, Maastricht, Netherlands

[23] VieCuri Med Ctr, Dept Internal Med, Venlo, Netherlands

[24] Maastricht Univ, Med Ctr, Dept Internal Med, Rheumatol, Maastricht, Netherlands

[25] Univ Hasselt, Hasselt, Belgium

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2017年 / 76卷 / 05期

关键词：

BONE-MINERAL DENSITY; COMPREHENSIVE GERIATRIC ASSESSMENT; STANDARDIZED OPERATING PROCEDURES; IMPROVE OSTEOPOROSIS TREATMENT; CLINICAL-PRACTICE GUIDELINE; RANDOMIZED CONTROLLED-TRIAL; FEMORAL-NECK FRACTURES; SHARED DECISION-MAKING; ORAL VITAMIN-D; HIP FRACTURE;

D O I：

10.1136/annrheumdis-2016-210289

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients. According to the EULAR standard operating procedures for the elaboration and implementation of evidence-based recommendations, 7 rheumatologists, a geriatrician and 10 orthopaedic surgeons met twice under the leadership of 2 convenors, a senior advisor, a clinical epidemiologist and 3 research fellows. After defining the content and procedures of the task force, 10 research questions were formulated, a comprehensive and systematic literature search was performed and the results were presented to the entire committee. 10 recommendations were formulated based on evidence from the literature and after discussion and consensus building in the group. The recommendations included appropriate medical and surgical perioperative care, which requires, especially in the elderly, a multidisciplinary approach including orthogeriatric care. A coordinator should setup a process for the systematic investigations for future fracture risk in all elderly patients with a recent fracture. High-risk patients should have appropriate non-pharmacological and pharmacological treatment to decrease the risk of subsequent fracture.

引用

页码：802 / 810

页数：9

共 107 条

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