Letter to the Editor
Secondary Fracture Prevention After Femur Fractures in the Gran Canaria North Health Area: A 2004–2014 Comparison
Prevención secundaria de fracturas tras fractura de fémur en el área norte de Gran Canaria: comparativa 2004–2014
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On average, the initial visit took place 6 months after the fracture in both studies. Data collection was carried out by five rheumatologists during the period from 2004 to 2006, and by a nurse from 2012 to 2014. The risk factors for fracture recorded during the two periods are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, in which the characteristics of the two groups are similar. In both periods, at the time of the first visit, less than 20% of the patients were taking a bisphosphonate.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The results of the present analysis show that, over a decade, there has been no progress in secondary prevention after a hip fracture. However, the findings encourage us to continue with the implementation of a model of patient care to oversee fracture prevention in this health area. The model consists of a secondary prevention unit for patients >50 years of age who have sustained a fragility fracture and, in the specific case of the hip, are receiving support from the orthogeriatric unit and the rehabilitation service.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A retrospective study conducted in Spain found that only 12% of the patients with a fractured hip received adequate treatment for osteoporosis at 5 years of follow-up,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> when the guidelines recommend treating all hip fracture patients.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> Secondary fracture prevention has been found to be cost-effective<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a>; moreover, several post-fracture secondary prevention programs have been successfully carried out in different countries.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion, over the last 10 years, the proportion of patients who receive treatment after a hip fracture remained under 20% in our province. One of the limitations of this study is the selection bias, as the patients analyzed do not represent all the hip fractures recorded during that period, but those patients who were interest in the study; in any case, we understand that the oldest patients with the greatest disability did not participate in the studies and the rate of treatment could be lower than that reported here. The low prescription rate in routine clinical practice is further evidence of the need to create fracture units or a fracture liaison service in Spain. We consider that this is an opportunity to broaden the field of rheumatology with active participation in secondary fracture prevention.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest related to this work.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Naranjo A, Ojeda-Bruno S, Bilbao Cantarero A, Rodríguez-Moreno S. Prevención secundaria de fracturas tras fractura de fémur en el área norte de Gran Canaria: comparativa 2004–2014. Reumatol Clin. 2016;12:58.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Scholarship: National Project of the Ministry of Science and Innovation. Carlos III Health Institute: PI11/01429.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BMI, body mass index; SD, standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2004–2006 Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012–2014 Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No. of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">198 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Women, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">142 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age, mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous fracture, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.54 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hip fractures in family history, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BMI <18.5, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.94 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Current smokers, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.19 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alcohol consumption, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Corticosteroids, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.89 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.46 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Secondary osteoporosis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous bisphosphonate therapy, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Treatment with bisphosphonate at the time of the baseline visit, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab979993.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the Patients With Hip Fracture During Two Periods of Observation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimate of the 10-year risk of osteoporotic fractures in the Spanish population" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. González López-Valcárcel" 1 => "M. Sosa Henríquez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2013" "volumen" => "140" "paginaInicial" => "104" "paginaFinal" => "109" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The risk of major and any (non-hip) fragility fracture after hip fracture in the United Kingdom: 2000–2010" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Gibson-Smith" 1 => "C. Klop" 2 => "P.J. Elders" 3 => "P.M. Welsing" 4 => "N. van Schoor" 5 => "H.G. Leufkens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-014-2799-x" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2014" "volumen" => "25" "paginaInicial" => "2555" "paginaFinal" => "2563" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25001987" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of the costs and consequences of adherence to therapy in hip fracture patients. Results of a longitudinal analysis of" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "U. Tarantino" 1 => "S. Ortolani" 2 => "L. Degli Esposti" 3 => "C. Veronesi" 4 => "S. Buda" 5 => "M.L. Brandi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Cases Miner Bone Metab" "fecha" => "2011" "volumen" => "8" "paginaInicial" => "57" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22461805" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secondary prevention program for osteoporotic fractures and long-term adherence to bisphosphonates" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Ojeda-Bruno" 1 => "A. Naranjo" 2 => "F. Francisco-Hernández" 3 => "C. Erausquin" 4 => "I. Rúa-Figueroa" 5 => "J.C. Quevedo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-010-1414-z" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2011" "volumen" => "22" "paginaInicial" => "1821" "paginaFinal" => "1828" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20924747" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Results of a model of secondary prevention for osteoporotic fracture coordinated by rheumatology and focused on the nurse and primary care physicians" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Naranjo" 1 => "S. Ojeda-Bruno" 2 => "A. Bilbao Cantarero" 3 => "J.C. Quevedo Abeledo" 4 => "L.A. Henriquez-Hernandez" 5 => "C. Rodriguez-Lozano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2013.12.007" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "299" "paginaFinal" => "303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24553244" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Failure to treat osteoporosis and the risk of subsequent fractures in elderly patients with previous hip fracture: a five-year retrospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Formiga" 1 => "A. Rivera" 2 => "J.M. Nolla" 3 => "A. Coscujuela" 4 => "A. Sole" 5 => "R. Pujol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aging Clin Exp Res" "fecha" => "2005" "volumen" => "17" "paginaInicial" => "96" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15977456" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aplicación de las guías de prevención secundaria de fractura osteoporótica y del índice FRAX en una cohorte de pacientes con fractura por fragilidad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Naranjo" 1 => "S. Ojeda-Bruno" 2 => "F. Francisco-Hernández" 3 => "C. Erausquin" 4 => "I. Rúa-Figueroa" 5 => "C. Rodríguez-Lozano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2011" "volumen" => "136" "paginaInicial" => "290" "paginaFinal" => "292" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secondary prevention of hip fracture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.H. George" 1 => "S. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2000" "volumen" => "39" "paginaInicial" => "346" "paginaFinal" => "349" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Ganda" 1 => "M. Puech" 2 => "J.S. Chen" 3 => "R. Speerin" 4 => "J. Bleasel" 5 => "J.R. Center" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-012-2090-y" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "393" "paginaFinal" => "406" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22829395" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001200000001/v1_201601240019/S2173574315001227/v1_201601240019/en/main.assets" "Apartado" => array:4 [ "identificador" => "8400" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001200000001/v1_201601240019/S2173574315001227/v1_201601240019/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574315001227?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 28 | 31 | 59 |
| 2024 September | 35 | 18 | 53 |
| 2024 August | 44 | 21 | 65 |
| 2024 July | 47 | 28 | 75 |
| 2024 June | 44 | 34 | 78 |
| 2024 May | 43 | 26 | 69 |
| 2024 April | 38 | 15 | 53 |
| 2024 March | 43 | 25 | 68 |
| 2024 February | 34 | 20 | 54 |
| 2024 January | 31 | 21 | 52 |
| 2023 December | 21 | 19 | 40 |
| 2023 November | 38 | 25 | 63 |
| 2023 October | 28 | 36 | 64 |
| 2023 September | 64 | 41 | 105 |
| 2023 August | 32 | 40 | 72 |
| 2023 July | 30 | 23 | 53 |
| 2023 June | 29 | 25 | 54 |
| 2023 May | 38 | 19 | 57 |
| 2023 April | 24 | 6 | 30 |
| 2023 March | 41 | 25 | 66 |
| 2023 February | 31 | 30 | 61 |
| 2023 January | 32 | 26 | 58 |
| 2022 December | 50 | 32 | 82 |
| 2022 November | 40 | 30 | 70 |
| 2022 October | 44 | 33 | 77 |
| 2022 September | 35 | 27 | 62 |
| 2022 August | 33 | 34 | 67 |
| 2022 July | 28 | 40 | 68 |
| 2022 June | 32 | 34 | 66 |
| 2022 May | 29 | 24 | 53 |
| 2022 April | 35 | 46 | 81 |
| 2022 March | 45 | 53 | 98 |
| 2022 February | 24 | 21 | 45 |
| 2022 January | 27 | 42 | 69 |
| 2021 December | 24 | 41 | 65 |
| 2021 November | 26 | 43 | 69 |
| 2021 October | 40 | 49 | 89 |
| 2021 September | 30 | 32 | 62 |
| 2021 August | 29 | 30 | 59 |
| 2021 July | 28 | 26 | 54 |
| 2021 June | 29 | 25 | 54 |
| 2021 May | 37 | 43 | 80 |
| 2021 April | 77 | 58 | 135 |
| 2021 March | 31 | 22 | 53 |
| 2021 February | 30 | 22 | 52 |
| 2021 January | 23 | 16 | 39 |
| 2020 December | 43 | 19 | 62 |
| 2020 November | 19 | 26 | 45 |
| 2020 October | 17 | 12 | 29 |
| 2020 September | 31 | 23 | 54 |
| 2020 August | 29 | 20 | 49 |
| 2020 July | 35 | 15 | 50 |
| 2020 June | 37 | 21 | 58 |
| 2020 May | 46 | 10 | 56 |
| 2020 April | 30 | 19 | 49 |
| 2020 March | 10 | 5 | 15 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 56 | 7 | 63 |
| 2018 March | 49 | 10 | 59 |
| 2018 February | 81 | 5 | 86 |
| 2018 January | 13 | 4 | 17 |
| 2017 December | 54 | 5 | 59 |
| 2017 November | 15 | 3 | 18 |
| 2017 October | 20 | 5 | 25 |
| 2017 September | 18 | 7 | 25 |
| 2017 August | 19 | 4 | 23 |
| 2017 July | 17 | 8 | 25 |
| 2017 June | 32 | 8 | 40 |
| 2017 May | 35 | 9 | 44 |
| 2017 April | 34 | 7 | 41 |
| 2017 March | 31 | 8 | 39 |
| 2017 February | 8 | 6 | 14 |
| 2017 January | 18 | 6 | 24 |
| 2016 December | 52 | 11 | 63 |
| 2016 November | 48 | 17 | 65 |
| 2016 October | 40 | 17 | 57 |
| 2016 September | 48 | 9 | 57 |
| 2016 August | 38 | 7 | 45 |
| 2016 July | 33 | 10 | 43 |
| 2016 June | 1 | 0 | 1 |
| 2016 February | 2 | 32 | 34 |
| 2016 January | 2 | 21 | 23 |
Show all
