Identification and Treatment of Osteoporosis among Elderly Patients with Hip Fractures

Abstract

OBJECTIVE:To evaluate the profile of osteoporosis treatment among patients hospitalized due to hip fractures at a tertiary-level university hospital. To compare the impact of hospitalization on approaches toward treating bone mass losses.METHOD:The medical records of 123 hip fracture patients aged 60 years and over at the Institute of Orthopedics, Hospital das Clínicas, University of São Paulo School of Medicine, between 2004 and 2006 were reviewed and analyzed with respect to approaches towards investigating osteoporosis and treatments before and after fracture.RESULTS:The patients’ mean age was 78 ± 8.3 years, and the majority were women (71.54%). The patients had a mean of 2.72 comorbidities and used 3.26 medications on average. Among these patients, 12.3% reported a previous diagnosis of osteoporosis, and 5.83% were on medication for this. The mean waiting time for surgery was 6.3 ± 7.54 days, and seven patients (5.7%) died during the hospitalization. There were no investigations using bone densitometry, no changes in osteoporosis therapy between admission and discharge (p = 0.375), and no reports of referrals for the patient to have access to treatment.CONCLUSIONS:Investigations and treatments of osteoporosis and strategies for preventing new fractures were not implemented during the hospitalization of these elderly patients with hip fractures, even though this is the most feared complication of osteoporosis. These data need to be disseminated so that professionals dealing with elderly patients are attentive to the need for primary and secondary prevention of osteoporosis because of the impact of fractures on these patients’ quality of life, independence, morbidities, and mortality.

Expression of TGF-β1 in the blood during fracture repair in an estrogen-deficient rat model

“…Osteoporotic fracture is of great clinical importance as it carries a high risk of morbidity and mortality. 1 Osteoporosis is a metabolic bone disease that results in decreased bone mass and an increased risk of fracture. 2 Postmenopausal osteoporosis is considered the most frequent cause of pathological fracture.…”

Can orthopedic surgeons help create a better head start for osteoporosis treatment after hip fracture?

“…Although osteoporotic fractures pose an immense economic and medical burden on society, treatment rates reported in the literature are still relatively low. [ 9 , 22 , 24 , 26 – 28 ] Only recently Bawa et al [ 29 ] showed in a very large retrospective study of patients suffering from primary fragility fracture (of 4 different types) that only 10% had received treatment for up to 3 years after the fracture, but there was up to a 40% risk reduction of a subsequent fracture in those patients who were prescribed antiosteoporotic treatment. In our study, we showed a significantly higher percentage of patients being treated, but this may be attributed to 2 important differences: we looked into only dietary supplementation and not bisphosphonate medication with its higher costs, and we included only hip fractures that, due to their medical severity, might raise attention for treatment as compared, for example, to a distal radius fracture.…”

Cirurgia ortopédica em idosos: aspectos clínicos

“…This serves as an alert regarding the need for clinicians to review prescriptions at the time of orthopedic discharge, in order to ensure that catastrophic events are prevented (28) .…”