Tuberculosis presenting as metastatic lung cancer.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: None 20. Osteoporos Int. 2025 Mar;36(3):501-512. doi: 10.1007/s00198-024-07376-y. Epub 2025 Jan 14. Fracture liaison service (FLS) is associated with lower subsequent fragility fracture risk and mortality: NoFRACT (the Norwegian capture the fracture initiative). Andreasen C(1)(2), Dahl C(3), Frihagen F(4)(5), Borgen TT(6), Basso T(7), Gjertsen JE(8)(9), Figved W(5)(10), Wisløff T(5)(11), Hagen G(12), Apalset EM(13)(14), Stutzer JM(15), Lund I(16), Hansen AK(1)(2), Nissen FI(1)(2)(17), Joakimsen RM(2)(18), Syversen U(19)(20), Eriksen EF(21)(22), Nordsletten L(5)(16), Omsland TK(3), Bjørnerem Å(2)(17)(23), Solberg LB(24). Author information: (1)Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway. (2)Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway. (3)Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway. (4)Department of Orthopedic Surgery, Østfold Hospital Trust, Grålum, Norway. (5)Institute of Clinical Medicine, University of Oslo, Oslo, Norway. (6)Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Drammen, Norway. (7)Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway. (8)Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway. (9)Department of Clinical Medicine, University of Bergen, Bergen, Norway. (10)Department of Orthopedic Surgery, Vestre Viken Hospital Trust, Bærum Hospital, Gjettum, Norway. (11)Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway. (12)Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway. (13)Bergen Group of Epidemiology and Biomarkers in Rheumatic Disease, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway. (14)Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. (15)Department of Orthopedic Surgery, Møre and Romsdal Hospital Trust, Hospital of Molde, Molde, Norway. (16)Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway. (17)Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway. (18)Department of Medicine, University Hospital of North Norway, Tromsø, Norway. (19)Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. (20)Department of Endocrinology, St. Olavs University Hospital, Trondheim, Norway. (21)Spesialistsenteret Pilestredet Park, Oslo, Norway. (22)Faculty of Dentistry, University of Oslo, Oslo, Norway. (23)Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway. (24)Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway. lenser@ous-hf.no. Subsequent fracture rates and associated mortality were compared before and after the introduction of fracture liaison service (FLS). In 100,198 women and men, FLS was associated with 13% and 10% lower risk of subsequent fragility fractures and 18% and 15% lower mortality. The study suggests that FLS may prevent fractures. PURPOSE: Efficient fracture prevention strategies are warranted to control the global fracture burden. We investigated the effect of a standardized fracture liaison service (FLS) intervention on subsequent fracture risk and mortality. METHODS: The NoFRACT study was designed as a multicenter, pragmatic, register-supported, stepped-wedge cluster-randomized trial. The FLS intervention was introduced in three clusters with 4-month intervals starting May 2015 through December 2018 and included evaluation of osteoporosis and treatment in patients over 50 years with a low-energy fracture. Based on data from the Norwegian Patient Registry, patients with index fractures were assigned to the control period (2011-2015) or intervention period (2015-2018) depending on the time of fracture. Rates of subsequent fragility fractures (distal forearm, proximal humerus, or hip) and all-cause mortality were calculated. RESULTS: A total of 100,198 patients (mean age 69.6 years) suffered an index fracture of any type. During a maximum follow-up of 4.7 years, 11% (6948) of the women and 6% (2014) of the men experienced a subsequent fragility fracture, and 20% (14,324) of the women and 22% (8,326) of the men died. FLS was associated with 13% lower subsequent fragility fracture risk in women (hazard ratio (HR) 0.87, 95% confidence intervals (CI) 0.83-0.92) and 10% in men (HR 0.90, 95% CI 0.81-0.99) and 18% lower mortality in women (HR 0.82, 95% CI 0.79-0.86) and 15% in men (HR 0.85, 95% CI 0.81-0.89). CONCLUSION: A standardized FLS intervention was associated with a lower risk of subsequent fragility fractures and mortality and may contribute to reduce the global fracture burden. © 2025. The Author(s). DOI: 10.1007/s00198-024-07376-y PMCID: PMC11882684