Course: Is Follow-up Co-Morbidity Assessment via Laboratory Investigations in Older High Energy Trauma Patients Justified? - A Prospective-Retrospective Study

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  • Select activity Is Follow-up Co-Morbidity Assessment via Laboratory Investigations in Older High Energy Trauma Patients Justified? - A Prospective-Retrospective Study

    INTRODUCTION

    As population is ageing in most parts of the world, and people are staying active until an older age, the number of elderly patients requiring trauma care is growing1 . As per estimates, geriatric patients with a fracture will represent 40% of all trauma patients by 20502 . Among the geriatric patients with a fracture one-fourth suffer from high-energy injuries, while rest present with a fragility fracture3 . 

    Older patients with a fracture require a special care, as compared to the younger population they sustain a more severe injury, require prolonged hospitalisation, and have a higher mortality rate1 . There exists a different treatment protocol in literature for older patients with low and high energy fractures. In addition to fracture treatment, patients with fragility fractures also undergo extensive laboratory analysis to diagnose any pre-existing comorbidities during their follow-up visit in the Fracture Liaison Service (FLS) clinic. 

    The FLS is a multidisciplinary dedicated approach to manage fragility fractures4 . A subclinical pre-existing medical condition compromising fracture healing can be present in more than a quarter of fragility fracture patients4-9. This approach of care has not only reduced the possibilities of secondary fractures but also have improved the quality of life and survival rates10.

    However, in the high energy group, comorbidities often go undiagnosed and untreated since there is no specific protocol available in the literature for managing comorbidities in them like a dedicated fracture liaison service. The present study was thus conducted with this intent in mind, to bring to the fore that high energy group of patients also require a specific protocol on the lines of fracture liaison service for detection of their comorbidities similar to the patients in the low energy group. The objective of the current study was to test our hypothesis that older patients sustaining high energy trauma will have altered laboratory parameters as frequently as the patients with fragility fractures of the same age group. Therefore, patients with high energy trauma need to be evaluated for their comorbidities, similar to geriatric patients sustaining low energy trauma.
    
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