Introduction Reduction in outpatient appointments during the COVID-19 pandemic and patient concern surrounding risk of contracting COVID-19 by attending day-case settings, resulted in delayed or cancelled medical treatments including Zoledronic Acid infusions as management for Osteoporosis. This, alongside recent research concluding that these treatments can be given safely as early as 1-2 weeks post-fracture, lead to the adaptation of protocol at Hull University Teaching Hospitals Trust in 2021, to provide rapid loading of Cholecalciferol over 6 days, prior to administration of Zoledronic Acid on day 7. However, some concerns remain surrounding the potential interference with bone remodelling and healing. This completed audit cycle evaluates the logistics and safety of this new protocol. Methods All patients over 60, admitted with neck of femur fracture who received Zoledronic Acid infusion as inpatient or outpatient in 2019 and 2021 were included in the initial and repeat audit respectively. Electronic records for the following 12 months were analysed evaluating for further fragility fracture and mortality rate. Results There was an increase in patients receiving Zoledronic Acid as an inpatient treatment from 21% in the initial audit to 97% in the repeat audit. There was a slight increase in mortality rate at one year from 14% to 19%. The percentage of a further fragility fracture within one year, remained stable at 7%. Conclusion The increase in inpatient infusions suggests more patients with significant frailty who would otherwise not have been able to attend outpatient settings, have been able to receive treatment. The mortality results reflect this frailer audit population. The absence of a substantial increase in the rate of further fragility fracture at one year; supports the earlier administration of Zoledronic Acid as a management protocol.

中文翻译：

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1912 回顾新冠疫情大流行对改变髋部骨折患者服用唑来膦酸临床实践的影响

简介 COVID-19 大流行期间门诊预约的减少以及患者对日间就诊时感染 COVID-19 风险的担忧，导致医疗治疗的延迟或取消，包括注射唑来膦酸治疗骨质疏松症。这与最近的研究得出的结论是，这些治疗最早可以在骨折后 1-2 周内安全进行，导致赫尔大学教学医院信托基金在 2021 年调整方案，在 6 天内快速加载胆钙化醇。第 7 天服用唑来膦酸。然而，围绕骨重塑和愈合的潜在干扰仍然存在一些担忧。这个完整的审核周期评估了这个新协议的后勤和安全性。方法 2019年和2021年住院或门诊接受唑来膦酸输注的60岁以上股骨颈骨折患者分别纳入初审和复审。对接下来 12 个月的电子记录进行了分析，评估进一步的脆性骨折和死亡率。结果 接受唑来膦酸住院治疗的患者比例从初次审核中的 21% 增加到重复审核中的 97%。一年死亡率略有上升，从 14% 升至 19%。一年内再次发生脆性骨折的比例稳定在 7%。结论 住院患者输液量的增加表明，更多原本无法前往门诊就诊的严重虚弱患者能够接受治疗。死亡率结果反映了审计人群的脆弱性。一年后进一步脆性骨折的发生率没有大幅增加；支持早期将唑来膦酸作为管理方案进行管理。