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Summary <p>Nearly 11% of subjects developed fragility fractures during the first year after LT despite following a CP. This study allowed for generating a fracture risk score, with a sensitivity of 80% and a specificity of 72%, for identifying high-risk subjects, thereby allowing a more adequate therapeutic approach in these patients.</p> Purpose/Introduction <p>The increased risk of skeletal fractures associated with liver transplantation (LT) led our group to develop a multidisciplinary care protocol (CP) for preventing fractures after LT. The aim of this study was to evaluate the effect of applying this CP on the incidence of fractures during the first year after LT and to evaluate the risk factors for fractures in these subjects.</p> Methods <p>Retrospective study of subjects referred for LT in a CP over a 7-year period. Clinical risk factors for fracture and densitometric and 25-OH vitamin D (25OHD) values were evaluated in all subjects as were spinal X-ray findings. Patients with a T-score &lt;  − 1 and/or previous fractures received bisphosphonates. A logistic regression model was used to analyze the risk of fracture. A predictive score for fracture risk was created.</p> Results <p>A total of 220 patients evaluated at 1&#xa0;year of follow-up after LT were included (70% men), mean age 55 + 9.7&#xa0;years. Before LT, 24% of patients had fragility fractures. Forty-seven percent had osteopenia, and 30% had osteoporosis at the lumbar spine, femoral neck, and total femur. During the first year after LT, 24 (10.9%) patients developed fractures. Age (&gt; 50&#xa0;years), history of previous fractures, and being a postmenopausal woman were the main risk factors related to incidental fractures. The predictive score for fracture risk based on these variables had a sensitivity of 80% and a specificity of 72%.</p> Conclusions <p>Nearly 11% of the patients developed fragility fractures during the first year after LT, despite following a CP. Identification of high-risk subjects is essential to improve the therapeutic approach in these patients.</p>

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Results of the implementation of a multidisciplinary care protocol for preventing fragility fractures following liver transplantation

  • 期刊论文

  • 发表日期：

    2025年5月22日

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  • A. Monegal,
  • J. L. Carrasco,
  • P. Peris,
  • B. Frade-Sosa,
  • A. Azuaga,
  • H. Florez,
  • A. Dura,
  • N. Guañabens,
  • J. Colmenero

摘要

Summary

Nearly 11% of subjects developed fragility fractures during the first year after LT despite following a CP. This study allowed for generating a fracture risk score, with a sensitivity of 80% and a specificity of 72%, for identifying high-risk subjects, thereby allowing a more adequate therapeutic approach in these patients.

Purpose/Introduction

The increased risk of skeletal fractures associated with liver transplantation (LT) led our group to develop a multidisciplinary care protocol (CP) for preventing fractures after LT. The aim of this study was to evaluate the effect of applying this CP on the incidence of fractures during the first year after LT and to evaluate the risk factors for fractures in these subjects.

Methods

Retrospective study of subjects referred for LT in a CP over a 7-year period. Clinical risk factors for fracture and densitometric and 25-OH vitamin D (25OHD) values were evaluated in all subjects as were spinal X-ray findings. Patients with a T-score <  − 1 and/or previous fractures received bisphosphonates. A logistic regression model was used to analyze the risk of fracture. A predictive score for fracture risk was created.

Results

A total of 220 patients evaluated at 1 year of follow-up after LT were included (70% men), mean age 55 + 9.7 years. Before LT, 24% of patients had fragility fractures. Forty-seven percent had osteopenia, and 30% had osteoporosis at the lumbar spine, femoral neck, and total femur. During the first year after LT, 24 (10.9%) patients developed fractures. Age (> 50 years), history of previous fractures, and being a postmenopausal woman were the main risk factors related to incidental fractures. The predictive score for fracture risk based on these variables had a sensitivity of 80% and a specificity of 72%.

Conclusions

Nearly 11% of the patients developed fragility fractures during the first year after LT, despite following a CP. Identification of high-risk subjects is essential to improve the therapeutic approach in these patients.