Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?

Rizkallah, Maroun; Bachour, Falah; Khoury, Mirvat El; Sebaaly, Amer; Finianos, Boutros; Hage, Rawad El; Maalouf, Ghassan

doi:10.1016/j.afos.2020.07.002

Cited by 21 publications

(16 citation statements)

References 47 publications

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“…Knowing the predictors of mortality is very useful because of the treatment plan for each patient individually, and in that way, the risk of death would be reduced [4,6,8]. Factors affecting mortality after hip fracture are: age, gender, poor mobility of the patient before fracture, poor mental status, dementia or cognitive impairment, diabetes, heart disease, cancer, comorbidities, higher ASA score, type of fracture, operative delay [5,10]. The mortality rate during hospital stay (intrahospital mortality) for patients with hip fracture in persons older than 70 years is between 2-20% [7,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Factors affecting mortality after hip fracture are: age, gender, poor mobility of the patient before fracture, poor mental status, dementia or cognitive impairment, diabetes, heart disease, cancer, comorbidities, higher ASA score, type of fracture, operative delay [5,10]. The mortality rate during hospital stay (intrahospital mortality) for patients with hip fracture in persons older than 70 years is between 2-20% [7,10,11]. It usually ranges from 5-7%, although in some studies it is significantly higher and is most often associated with the effects of acute trauma on the patient, length of hospital stay in the postoperative period, worsening of existing comorbidities, and possible surgical postoperative complications [4,5,11].…”

Section: Discussionmentioning

confidence: 99%

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Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Petrović¹,

Dimić²,

Bozovic³

et al. 2022

Srp Arh Celok Lek

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Introduction/Objective. Epidemiological research shows that we have a dramatic increase in the number of people with hip fractures, especially those over 65 years of age. The objectives of this study are to assess the association between preoperative comorbidity and the risk of postoperative complications and mortality and postoperative worsening of comorbid conditions and their relationship to mortality within one year of hip fracture surgery. Methods. In this retrospective study, from January 2018 until January 2020, 64 patients with hip fractures were operated on at the Department of Orthopedic Surgery in Kosovska Mitrovica. We monitored the number of comorbidities and their significance on the preoperative risk and the course of concomitant diseases in the postoperative period and one-year mortality after surgery, in patients with hip fractures. Results. We collected data on patients from the moment of admission to discharge from the hospital accompanied by medical histories, and after discharge after follow-up examinations, six months and one year from discharge. Of the total number of subjects, 23 (35.9%) had one or two comorbidities, most often of cardiac and neurological nature, in 25 patients (39.1%) we had three concomitant diseases, and in 11 (17.2%) four and more comorbidities. The mean age of the patients was 72.51 years (69?92 years). Conclusion. Approximately 45?60% of men and women who suffer a hip fracture have three or more comorbid states. In older people with hip fractures, the presence of three or more comorbidities is the strongest preoperative risk factor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Petrović¹,

Dimić²,

Bozovic³

et al. 2022

Srp Arh Celok Lek

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“…In limited studies, hip fracture is associated with significantly increased mortality than VCF, reaching 32.1% compared to 10%, respectively; however, the latter is associated with more morbidity. 9 It is proven in multiple studies that osteoporosis treatment in vertebral and nonvertebral fracture can reduce mortality in older, frailer individuals who are at high risk of fracture. In the meta-analysis, osteoporosis treatment was associated with an 11% reduction in mortality.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the 10 Years’ Association Between DXA Screening and Mortality in Patients Who Received Vertebroplasty in the Taiwan Population

Wu¹,

Lin²,

Chen³

et al. 2021

RMHP

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Background: Osteoporotic fractures are a significant cause of morbidity and mortality affecting population worldwide. All guidelines recommended vertebral fracture assessment by dual-energy X-ray absorptiometry (DXA). This study aimed at evaluation of any associated benefits of screening with DXA in patients who had received vertebroplasty in Taiwan. Methods: Data were obtained from the National Health Insurance Research Database (NHIRD) in Taiwan. We retrospectively compared the data of patients, who were admitted for vertebroplasty, whether they received DXA screening or not. The outcomes of interest were recurrence of spinal fracture and mortality during a follow-up period of 10 years. Results: From this Taiwan national database, the screening rate of osteoporosis in patient who received vertebroplasty was 11.7%. The mean age in the non-DXA screened cohort (n=32,986) was 74.03±12.21 years (71.98% female). In the DXA screened cohort (n=4361), the mean age was 76.43±9.19 years (79.91% female). During the 10-year follow-up period, after matching, non-DXA patients had significantly higher mortality rates than their DXA counterparts, which were 42.37% and 37.73% (p-value < 0.0001), respectively. The refracture rates between non-DXA and DXA patients were not significantly different at 17.26% and 16.89% (p-value = 0.1766), respectively. Conclusion:The rate of DXA screening before patients receiving vertebroplasty was extremely low, at 11.7%. Our results showed that DXA screening before vertebroplasty in spinal fractures patients had lower mortality. From this national retrospective cohort study, routine screening of osteoporosis in spinal fracture patients can lead to reduction in mortality.

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“…Hip and vertebral fractures are associated with high morbidity and mortality risk, and several studies have reported that mortality risk increases after a hip and vertebra fracture [4,5]. Almost 20-30% of all hip fracture patients die within 1 year of the fracture [6], and only 40-70% of the survivors achieve pre-fracture mobility and normal daily living activity and independence levels.…”

Section: Introductionmentioning

confidence: 99%

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

et al. 2021

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Purpose The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. Methods Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. Results There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. ConclusionWe suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally. KeywordsOsteoporosis • Current situation • Turkey • Older • Improvement Abbreviations BMD Bone mineral density DXA Dual-energy X-ray absorptiometry eGFR Estimated glomerular filtration rate ESCEO Economic evaluation of osteoporosis and osteoarthritis * Gulistan Bahat

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Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?

Cited by 21 publications

References 47 publications

Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Influence of comorbidity on postoperative course and mortality in patients with hip fracture

Evaluation of the 10 Years’ Association Between DXA Screening and Mortality in Patients Who Received Vertebroplasty in the Taiwan Population

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

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