Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)
Purpose To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry). Methods We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational...
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| Veröffentlicht in: | Endocrine 2021-02, Vol.71 (2), p.484-493 |
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| creator | Pepe, Jessica Agosti, Pasquale Cipriani, Cristiana Tettamanti, Mauro Nobili, Alessandro Colangelo, Luciano Santori, Rachele Cilli, Mirella Minisola, Salvatore |
| description | Purpose
To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry).
Methods
We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805–813, 820–823.
Results
Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%,
p
= 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients,
p
|
| doi_str_mv | 10.1007/s12020-020-02553-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_pubmed_primary_33433894</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2477263380</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-472fefbdeb68bd0702267faad39ab620d404c543e0bcf542a46f6f77592fa45a3</originalsourceid><addsrcrecordid>eNp9kd1qFTEQx4MotlZfwAsJeFMv1s7mY3P2UkqrBwot1YJ3S3YzOabsJsckS-lz9IXNutWCF0KGDDO_mcnkT8jbGj7WAOok1QwYVKtJySv5jBzWUrYVlPzz4nMpK4DN9wPyKqVbAMZYo16SA84F55tWHJKHG28wGqd3PiSXqPaGzksoR9R5Qp9psDSkjGEfYshuoHudXYkX1kwuZzTU-XIyRq9HOqFxg_NI73Q0aUltsx7vaY_5DtFTVt72e0pxGnqcfyC9Pru6_Lql17hzZU788Jq8sHpM-ObxPiI352ffTr9UF5eft6efLqqBK5kroZhF2xvsm01vQMGynNXa8Fb3DQMjQAxScIR-sFIwLRrbWKVky6wWUvMjcrz23cfwc8aUu8mlAcdRewxz6phQijXlo6Cg7_9Bb8O87LtQm7aGum5kodhKDTGkFNF2--gmHe-7GrpFsm6VrFutSNYtRe8eW899-by_JX80KgBfgVRSfofxafZ_2v4C4dmhkQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2489101165</pqid></control><display><type>article</type><title>Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)</title><source>Springer Nature - Complete Springer Journals</source><creator>Pepe, Jessica ; Agosti, Pasquale ; Cipriani, Cristiana ; Tettamanti, Mauro ; Nobili, Alessandro ; Colangelo, Luciano ; Santori, Rachele ; Cilli, Mirella ; Minisola, Salvatore</creator><creatorcontrib>Pepe, Jessica ; Agosti, Pasquale ; Cipriani, Cristiana ; Tettamanti, Mauro ; Nobili, Alessandro ; Colangelo, Luciano ; Santori, Rachele ; Cilli, Mirella ; Minisola, Salvatore ; Reposi investigators</creatorcontrib><description>Purpose
To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry).
Methods
We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805–813, 820–823.
Results
Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%,
p
= 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients,
p
< 0.0001). Among osteoporotic patients deceased 3 months after discharge, the number of those treated with vitamin D, with or without calcium supplements, was significantly lower compared with survivors (12 vs. 32%,
p
= 0.0168).
Conclusions
The diagnosis of osteoporosis is poorly considered both during hospital stay and at discharge; osteoporotic patients are frailer compared to non-osteoporotic patients.</description><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-020-02553-5</identifier><identifier>PMID: 33433894</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bisphosphonates ; Calcium ; Cognitive ability ; Creatinine ; Diabetes ; Diagnosis ; Endocrinology ; Geriatrics ; Hemoglobin ; Humanities and Social Sciences ; Internal Medicine ; Medicine ; Medicine & Public Health ; multidisciplinary ; Original Article ; Osteoporosis ; Patients ; Rehabilitation ; Science ; Vitamin D</subject><ispartof>Endocrine, 2021-02, Vol.71 (2), p.484-493</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-472fefbdeb68bd0702267faad39ab620d404c543e0bcf542a46f6f77592fa45a3</citedby><cites>FETCH-LOGICAL-c375t-472fefbdeb68bd0702267faad39ab620d404c543e0bcf542a46f6f77592fa45a3</cites><orcidid>0000-0003-1566-6553</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12020-020-02553-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12020-020-02553-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33433894$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pepe, Jessica</creatorcontrib><creatorcontrib>Agosti, Pasquale</creatorcontrib><creatorcontrib>Cipriani, Cristiana</creatorcontrib><creatorcontrib>Tettamanti, Mauro</creatorcontrib><creatorcontrib>Nobili, Alessandro</creatorcontrib><creatorcontrib>Colangelo, Luciano</creatorcontrib><creatorcontrib>Santori, Rachele</creatorcontrib><creatorcontrib>Cilli, Mirella</creatorcontrib><creatorcontrib>Minisola, Salvatore</creatorcontrib><creatorcontrib>Reposi investigators</creatorcontrib><title>Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>Purpose
To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry).
Methods
We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805–813, 820–823.
Results
Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%,
p
= 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients,
p
< 0.0001). Among osteoporotic patients deceased 3 months after discharge, the number of those treated with vitamin D, with or without calcium supplements, was significantly lower compared with survivors (12 vs. 32%,
p
= 0.0168).
Conclusions
The diagnosis of osteoporosis is poorly considered both during hospital stay and at discharge; osteoporotic patients are frailer compared to non-osteoporotic patients.</description><subject>Bisphosphonates</subject><subject>Calcium</subject><subject>Cognitive ability</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Endocrinology</subject><subject>Geriatrics</subject><subject>Hemoglobin</subject><subject>Humanities and Social Sciences</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>multidisciplinary</subject><subject>Original Article</subject><subject>Osteoporosis</subject><subject>Patients</subject><subject>Rehabilitation</subject><subject>Science</subject><subject>Vitamin D</subject><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kd1qFTEQx4MotlZfwAsJeFMv1s7mY3P2UkqrBwot1YJ3S3YzOabsJsckS-lz9IXNutWCF0KGDDO_mcnkT8jbGj7WAOok1QwYVKtJySv5jBzWUrYVlPzz4nMpK4DN9wPyKqVbAMZYo16SA84F55tWHJKHG28wGqd3PiSXqPaGzksoR9R5Qp9psDSkjGEfYshuoHudXYkX1kwuZzTU-XIyRq9HOqFxg_NI73Q0aUltsx7vaY_5DtFTVt72e0pxGnqcfyC9Pru6_Lql17hzZU788Jq8sHpM-ObxPiI352ffTr9UF5eft6efLqqBK5kroZhF2xvsm01vQMGynNXa8Fb3DQMjQAxScIR-sFIwLRrbWKVky6wWUvMjcrz23cfwc8aUu8mlAcdRewxz6phQijXlo6Cg7_9Bb8O87LtQm7aGum5kodhKDTGkFNF2--gmHe-7GrpFsm6VrFutSNYtRe8eW899-by_JX80KgBfgVRSfofxafZ_2v4C4dmhkQ</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Pepe, Jessica</creator><creator>Agosti, Pasquale</creator><creator>Cipriani, Cristiana</creator><creator>Tettamanti, Mauro</creator><creator>Nobili, Alessandro</creator><creator>Colangelo, Luciano</creator><creator>Santori, Rachele</creator><creator>Cilli, Mirella</creator><creator>Minisola, Salvatore</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1566-6553</orcidid></search><sort><creationdate>20210201</creationdate><title>Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)</title><author>Pepe, Jessica ; Agosti, Pasquale ; Cipriani, Cristiana ; Tettamanti, Mauro ; Nobili, Alessandro ; Colangelo, Luciano ; Santori, Rachele ; Cilli, Mirella ; Minisola, Salvatore</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-472fefbdeb68bd0702267faad39ab620d404c543e0bcf542a46f6f77592fa45a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bisphosphonates</topic><topic>Calcium</topic><topic>Cognitive ability</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diagnosis</topic><topic>Endocrinology</topic><topic>Geriatrics</topic><topic>Hemoglobin</topic><topic>Humanities and Social Sciences</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>multidisciplinary</topic><topic>Original Article</topic><topic>Osteoporosis</topic><topic>Patients</topic><topic>Rehabilitation</topic><topic>Science</topic><topic>Vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pepe, Jessica</creatorcontrib><creatorcontrib>Agosti, Pasquale</creatorcontrib><creatorcontrib>Cipriani, Cristiana</creatorcontrib><creatorcontrib>Tettamanti, Mauro</creatorcontrib><creatorcontrib>Nobili, Alessandro</creatorcontrib><creatorcontrib>Colangelo, Luciano</creatorcontrib><creatorcontrib>Santori, Rachele</creatorcontrib><creatorcontrib>Cilli, Mirella</creatorcontrib><creatorcontrib>Minisola, Salvatore</creatorcontrib><creatorcontrib>Reposi investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pepe, Jessica</au><au>Agosti, Pasquale</au><au>Cipriani, Cristiana</au><au>Tettamanti, Mauro</au><au>Nobili, Alessandro</au><au>Colangelo, Luciano</au><au>Santori, Rachele</au><au>Cilli, Mirella</au><au>Minisola, Salvatore</au><aucorp>Reposi investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>71</volume><issue>2</issue><spage>484</spage><epage>493</epage><pages>484-493</pages><issn>1355-008X</issn><eissn>1559-0100</eissn><abstract>Purpose
To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry).
Methods
We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805–813, 820–823.
Results
Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%,
p
= 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients,
p
< 0.0001). Among osteoporotic patients deceased 3 months after discharge, the number of those treated with vitamin D, with or without calcium supplements, was significantly lower compared with survivors (12 vs. 32%,
p
= 0.0168).
Conclusions
The diagnosis of osteoporosis is poorly considered both during hospital stay and at discharge; osteoporotic patients are frailer compared to non-osteoporotic patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33433894</pmid><doi>10.1007/s12020-020-02553-5</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1566-6553</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Endocrine, 2021-02, Vol.71 (2), p.484-493 |
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| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Bisphosphonates Calcium Cognitive ability Creatinine Diabetes Diagnosis Endocrinology Geriatrics Hemoglobin Humanities and Social Sciences Internal Medicine Medicine Medicine & Public Health multidisciplinary Original Article Osteoporosis Patients Rehabilitation Science Vitamin D |
| title | Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register) |
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