Elevada morbimortalidade e reduzida taxa de diagnóstico de osteoporose em idosos com fratura de fêmur proximal na cidade de São Paulo

Fortes, Érika Miyamoto Unifesp]; Raffaelli, Maurício P.; Bracco, Oswaldo Luís; Takata, Edmilson Takehiro; Reis, Fernando Baldy dos; Santili, Cláudio; Lazaretti‐Castro, Marise

doi:10.1590/s0004-27302008000700006

Cited by 24 publications

(17 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The lack of a diagnosis following a fracture event is a major problem in many countries, including Brazil. 10,23,24 It is highly concerning since osteoporotic fracture, especially hip fracture, is associated to higher mortality rate (23.2%) and prevalence of disability (30%). 10 Furthermore, it should be stressed that the current treatment of osteoporosis can reduce the risk of vertebral (50% to 65%) as well as non-vertebral fractures (25% to 40%).…”

Section: Discussionmentioning

confidence: 99%

“…10,23,24 It is highly concerning since osteoporotic fracture, especially hip fracture, is associated to higher mortality rate (23.2%) and prevalence of disability (30%). 10 Furthermore, it should be stressed that the current treatment of osteoporosis can reduce the risk of vertebral (50% to 65%) as well as non-vertebral fractures (25% to 40%). Therefore, it is unacceptable that individuals with a previous event and those at a high risk of fracture be deprived of safe, effective and cost-efficient treatment for the prevention of bone loss and further events.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

et al. 2010

View full text Add to dashboard Cite

OBJECTIVE: To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women. METHODS: Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD) as the dependent variables and all other parameters as the independent ones. The significance level was set at p<0.05. RESULTS: The prevalence of osteoporosis and osteoporotic fractures was 33% and 11.5%, respectively. The main risk factors associated with low bone mass were age (OR=1.07; 95% CI: 1.06;1.08), time since menopause (OR=2.16; 95% CI: 1.49;3.14), previous fracture (OR=2.62; 95% CI: 2.08;3.29) and current smoking (OR=1.45; 95% CI: 1.13;1.85). BMI (OR=0.88; 95% CI: 0.86;0.89), regular physical activity (OR=0.78; 95% CI: 0.65;0.94) and hormone replacement therapy (OR=0.43; 95% CI: 0.33;0.56) had a protective effect on bone mass. Risk factors significantly associated with osteoporotic fractures were age (OR=1.05; 95% CI: 1.04;1.06), time since menopause (OR=4.12; 95% CI: 1.79;9.48), familial history of hip fracture (OR=3.59; 95% CI: 2.88;4.47) and low BMD (OR=2.28; 95% CI: 1.85;2.82). CONCLUSIONS: Advanced age, menopause, low-trauma fracture and current smoking are major risk factors associated with low BMD and osteoporotic fracture. The clinical use of these parameters to identify women at higher risk for fractures might be a reasonable strategy to improve the management of osteoporosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

et al. 2010

View full text Add to dashboard Cite

show abstract

“…6 In addition to high mortality, femoral fracture also presents a high morbidity rate and functional impairment, causing a psychosocial impact with the degree of post-fracture dependence, reaching 30%. 7,8 Total expenditures on hospitalization for femoral fractures in the elderly in Brazil were around 40 million R$ per year in the threeyear period of 2006-2008, representing about 2% of all causes of hospitalization among the elderly. 9 Driven by the absence of data on osteoporotic femoral fractures in the State of Paraná and the need to know the magnitude of the problem and its costs to the public health care system (SUS), the present study aims to assess the incidence and economic impact that this morbidity represented for the state in the period from January 2010 to December 2014.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Femur Fractures in the Elderly and Cost to the State of Paraná, Brazil

Oliveira

Borba

2017

Acta ortop. bras.

View full text Add to dashboard Cite

Objectives: To evaluate the incidence and economic impact of femur fractures in the state of Paraná, Brazil. Methods: This descriptive study included men and women ≥ 60 years of age with hip fractures which were treated by the Public Health System in emergency care from January 2010 to December 2014. Data were collected from the DATASUS public health database using filters to select patients; results were presented descriptively and as proportions. The standardized incidence of femur fracture was calculated by sex and age for 10,000 inhabitants in Paraná state and in Brazil for the year 2012. Results: During the study period, 11,226 fractures were registered, 66.8% in women and 33.2% in men. There was a preponderance of fractures in Caucasians and in older age groups. Mortality during hospitalization was 5.9%, higher in males, in patients aged ≥80 years, and in Blacks and Asians. The total cost was R$ 29,393,442.78 and the average cost per hospitalization was R$ 2,618.34. The eastern region of the state had the highest rate of fractures, predominantly in the capital, Curitiba. The standardized incidence rate was higher in females and in the population of Paraná. Conclusion: Femur fractures have a high incidence rate in the elderly population of Paraná and a large economic impact.

show abstract

“…After a significant event such as a hip fracture, 13.9% of patients were diagnosed with osteoporosis and 11.6% were started on some kind of treatment upo discharge from hospital. 14 There is controversy in the literature regarding the use of medication to prevent fractures which could occur 20 or 30 years after starting treatment. 3,15 However, bisphosphonates are still the most widely used drugs for treating postmenopausal osteoporosis and have shown good efficacy in increasing bone mineral density and reducing the incidence of fractures.…”

Section: Discussionmentioning

confidence: 99%

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

et al. 2013

View full text Add to dashboard Cite

OBJECTIVE:To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS:A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using highcost medications for the treatment of postmenopausal osteoporosis, between 2000 and 2006.Mean monthly spending on medicines was stratifi ed by age group and described according to demographic and clinical characteristics and the type of drug used.A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS:We identifi ed 72,265 women who received drugs for the treatment of postmenopausal osteoporosis.The average monthly expenditure per capita in the fi rst year of treatment was $ 54.02 (sd $ 86.72).The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline.For most of the patients, the same active ingredient remained in use throughout the treatment period.During the program, 6,429 deaths were identifi ed among participants.More than a third of women remained in treatment for up to 12 months.Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS:Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.

show abstract

Elevada morbimortalidade e reduzida taxa de diagnóstico de osteoporose em idosos com fratura de fêmur proximal na cidade de São Paulo

Cited by 24 publications

References 51 publications

Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

Epidemiology of Femur Fractures in the Elderly and Cost to the State of Paraná, Brazil

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

Contact Info

Product

Resources

About