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A Method to Estimate Cadaveric Femur Cortical Strains During Fracture Testing Using Digital Image Correlation
Published on: September 14, 2017
Cardiovascular risk factor analysis in patients with a recent clinical fracture at the fracture liaison service
Caroline E Wyers1, Lisanne Vranken1, Robert Y van der Velde2
1Department of Internal Medicine, VieCuri Medical Centre, P.O. Box 1926, 5900 BX Venlo, The Netherlands ; Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Insights
Patients with fractures often have underlying cardiovascular diseases (CVD) and venous thromboembolic events (VTE). This risk increases with age, highlighting the need for comprehensive medical history evaluation in fracture patients.
Area of Science:
- Gerontology
- Cardiology
- Endocrinology
- Orthopedics
- Epidemiology
Background:
- Low bone mineral density is linked to increased risks of cardiovascular diseases (CVD) and venous thromboembolic events (VTE).
- Fracture Liaison Services (FLS) offer a critical point for assessing fracture risk and associated comorbidities.
Purpose of the Study:
- To determine the prevalence of CVD, VTE, hypertension (HT), and diabetes mellitus type 2 (DM2) in patients presenting with recent clinical fractures to an FLS.
- To analyze the association of these comorbidities with patient demographics and fracture characteristics.
Main Methods:
- Retrospective chart review of 1359 patients aged 50-90 years attending an FLS for fracture risk evaluation.
- Data collection included medical history of CVD, VTE, HT, and DM2, alongside demographic and fracture information.
Main Results:
- A significant prevalence of comorbidities was observed: 29.9% of patients had a history of CVD, VTE, HT, DM2, or a combination.
- Comorbidity prevalence increased substantially with age, from 21% in the 50-59 age group to 48% in those over 80.
- Comorbidities were more prevalent in men (36%) than women (27%) and were independent of bone mineral density and fracture type.
Conclusions:
- Patients with recent clinical fractures frequently present with significant cardiovascular and thromboembolic risk factors.
- Age is a key determinant of comorbidity prevalence in this population.
- Thorough medical history assessment is crucial in fracture patients, especially before initiating medications that may increase VTE or cardiovascular event risk.
Abstract:
Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD) and venous thromboembolic events (VTE). The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT), and diabetes mellitus type 2 (DM2) in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS). Out of 3057 patients aged 50-90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs). Based on medical history, 29.9% had a history of CVD (13.7%), VTE (1.7%), HT (14.9%), and DM2 (7.1%) or a combination. Their prevalence increased with age (21% in patients aged 50-59 years to 48% in patients aged >80 years) and was higher in men than in women (36% versus 27%), but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.
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