title: A Year of Fractures: a snapshot analysis of the logistics, problems and outcomes of a hospital-based fracture liaison service.
abstract: CONCLUSIONS
  Our fracture liaison service identifies patients with low trauma fractures, determines the need for osteoporosis therapy and instigates therapy if necessary. We describe the tracking and outcome of 768 patients attending our emergency department over 1 year and discuss the problems we encountered and potential solutions.
  
  
  BACKGROUND
  Osteoporotic fractures result in substantial morbidity, mortality and economic cost, and patients sustaining a first fracture are known to be at higher risk of sustaining future fracture. Treatment of at-risk patients has been shown to assist in prevention of future fracture including hip fracture. We established a "First Fracture Project" to identify and treat these patients in 2003.
  
  
  METHODS
  We assessed "A Year of Fractures": the logistics, outcome and problems in tracking patients presenting to our emergency department with a low trauma fracture by our fracture liaison service, over 1 year from July 2008 to June 2009. Patients were tracked by our osteoporosis nurse and offered assessment, and treatment where necessary.
  
  
  RESULTS
  In 1 year, 768 patients aged 50 or over were identified from emergency department records as attending with a low trauma fracture. About 84 % of patients eventually received assessment. Of the162 patients progressing through the entire process, 74 % had osteoporosis treatment planned and/or commenced.
  
  
  CONCLUSIONS
  Our fracture liaison service was effective at identifying most low trauma fracture patients at risk of further fracture and providing access to osteoporosis assessment. There were many difficulties: we outline logistic and practical issues in delivering our service and suggest potential improvements.
authors.affiliation: Department of Rheumatology, Institute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia, janvaile@mail.usyd.edu.au.
authors.forename: J H
authors.initials: JH
authors.lastname: Vaile
authors.forename: L
authors.initials: L
authors.lastname: Sullivan
authors.forename: D
authors.initials: D
authors.lastname: Connor
authors.forename: J F
authors.initials: JF
authors.lastname: Bleasel
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000008:administration & dosage; D003266:Continuity of Patient Care / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000451:nursing / Q000517:prevention & control; D017063:Outcome Assessment, Health Care / Q000379:methods; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration; D055502:Secondary Prevention / Q000458:organization & administration
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary