Daniel Martinez-Laguna1, Alberto Soria-Castro1, Cristina Carbonell-Abella1, Pilar Orozco-López2, Pilar Estrada-Laza2, Xavier Nogues3, Adolfo Díez-Perez3, Daniel Prieto-Alhambra4. 1. GREMPAL Research Group, Idiap Jordi Gol Primary Care Research Institute, CIBER FES ISCIII, Universitat Autonoma de Barcelona, Barcelona, Spain; Ambit Barcelona, Primary Care Department, Institut Català de la Salut, Barcelona, Spain. 2. Ambit Barcelona, Primary Care Department, Institut Català de la Salut, Barcelona, Spain. 3. Internal Medicine Department IMIM (Hospital del Mar Medical Research), Universitat Autónoma de Barcelona, CIBER FES ISCIII, Barcelona, Spain. 4. GREMPAL Research Group, Idiap Jordi Gol Primary Care Research Institute, CIBER FES ISCIII, Universitat Autonoma de Barcelona, Barcelona, Spain; Internal Medicine Department IMIM (Hospital del Mar Medical Research), Universitat Autónoma de Barcelona, CIBER FES ISCIII, Barcelona, Spain; MRC Lifecourse Epidemiology Unit, Southampton University, Southampton, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Oxford Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. Electronic address: Daniel.prietoalhambra@ndorms.ox.ac.uk.
Abstract
PURPOSE: Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. METHODS: Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. RESULTS: Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. CONCLUSIONS: More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures.
PURPOSE: Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. METHODS:Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. RESULTS: Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. CONCLUSIONS: More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures.
Keywords:
Electronic medical records; Epidemiology; Epidemiología; Factores de riesgo; Fracturas por fragilidad; Fragility fracture; Historia clínica informatizada; Osteoporosis; Risk factors
Authors: Junqing Xie; Victoria Y Strauss; Daniel Martinez-Laguna; Cristina Carbonell-Abella; Adolfo Diez-Perez; Xavier Nogues; Gary S Collins; Sara Khalid; Antonella Delmestri; Aleksandra Turkiewicz; Martin Englund; Mina Tadrous; Carlen Reyes; Daniel Prieto-Alhambra Journal: JAMA Date: 2021-10-19 Impact factor: 56.272
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