Effects of Zoledronate on Mortality and Morbidity after Surgical Treatment of Hip Fractures

Cengîz, Ömer; Polat, Gökhan; Karademir, Gökhan; Tunç, Oytun Derya; Erdil, Mehmet; Tuncay, İbrahim; Şen, Cengiz

doi:10.1155/2016/3703482

Cited by 16 publications

(19 citation statements)

References 50 publications

(59 reference statements)

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“…Zoledronic acid (5 mg) was given to patients with hip fractures during the period of hospitalization and ensured the compliance of patients. Zoledronic acid significantly reduced new clinical vertebral fractures and clinical non‐vertebral fractures, and improved functional outcomes with good results for the Harris hip score and the Merle d'Aubigné scale from the 6th week to the 12th month after surgical management of hip fracture. It is surprising that anti‐osteoporosis medications may reduce the all‐cause mortality of patients with hip fractures.…”

Section: Discussionmentioning

confidence: 99%

“…first reported in 2007 that zoledronic acid reduced the mortality in the patients with hip fractures from 13.3% to 9.6% compared with the placebo group in the 3 year Recurrent Fracture Trial. Cengiz et al . reported in 2016 that 5 mg of zoledronic acid significantly reduced the first year mortality in the patients with intertrochanteric femoral fractures from 34.5% in the control group to 14.3% in the treatment group.…”

Section: Discussionmentioning

confidence: 99%

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Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Wang

Zhuang

et al. 2019

Orthopaedic Surgery

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ObjectiveTo study the effect of anti‐osteoporosis therapies on mortality after hip fracture.MethodsThis retrospective study was carried out in the Second Affiliated Hospital of Fujian Medical University and enrolled 690 patients 50 years of age and older who were admitted with hip fractures between 2010 and 2015. The patients were followed in 2017: 690 patients aged was from 50 to 103 years. There were 456 women and 234 men. There were 335 patients with fractures of the femoral neck and 355 patients with intertrochanteric fractures of the femur. There were 444 (64.35%) patients who also had internal diseases. The Charlson comorbidity index was 0–6. The anti‐osteoporosis medications were classified into no anti‐osteoporosis medication, calcium + vitamin D supplementations, non‐bisphosphonate medication, and bisphosphonate medication. The physicians followed the patients or family members by personal visit and telephone. Multivariable Cox regression analyses were done with known risk factors for mortality of hip fracture, such as gender, age, number of combined internal diseases, fracture type, place of residence, and Charlson comorbidity index, to show which anti‐osteoporosis medications had significant effects on mortality after adjustment for these variables.ResultsOut of 690 patients with hip fractures, 149 patients received no anti‐osteoporosis medication, 63 patients received calcium +vitamin D supplementations, 398 patients received non‐bisphosphonate medication, and 80 patients received bisphosphonate medication. The patients were followed between 7 months and 52 months, with the average of 28.53 ± 9.75 months. A total of 166 patients died during the follow‐up period. Of 166 deaths, 43 occurred within 3 months, 65 within 6 months, and 99 within 1 year after the hip fracture. In this study, fracture type, place of residence, and Charlson comorbidity index were not associated with the mortality, and the male gender, age > 75 years, and ≥ 2 combined internal diseases were the independent factors for deaths post‐hip fracture. The cumulative mortality was 36.24% in the patients receiving no anti‐osteoporosis medication. The hazard ratio for mortality after hip fracture with bisphosphonate medication, non‐bisphosphonate medication, and calcium/vitamin D supplementation was 0.355 (95% CI, 0.194–0.648), 0.492 (95% CI, 0.347–0.699) and 0.616 (95% CI, 0.341–1.114), respectively, as compared with no anti‐osteoporosis group. Bisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with the reduction of cumulative mortality post‐hip fracture (P < 0.01).ConclusionsBisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with decreased mortality after fragility hip fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Wang

Zhuang

et al. 2019

Orthopaedic Surgery

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“…The mean duration of healing was found to be 13 ± 3.2 and 15 ± 4.6 weeks, respectively, for treatment and control groups. In the study by Cengiz et al 31 on 114 patients with intertrochanteric femoral fractures, no significant difference was found between treatment groups administered zoledronate and the placebo group in terms of American Society of Anesthesiologists (ASA) scores at 1 year after surgical treatment by osteosynthesis. The mean HHS was found to be 81.93 and 72.9 in treatment and control groups, respectively, being significantly better in the treatment group.…”

Section: Discussionmentioning

confidence: 96%

“…Significant improvements in hip BMD and functional outcomes were reported with 12 months of BP treatment. 8 , 30 , 31 Li et al 30 divided 60 OP patients with intertrochanteric fractures to whom they treated surgically with the PFN. The treatment group was given an annual 5 mg ZolA, calcium, and vitamin D, while the control group was given solely calcium and vitamin D. After 1 year, significant increases in BMD were established in both treatment and control groups.…”

Section: Discussionmentioning

confidence: 99%

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Sargın¹,

Konya²,

Gülcü³

et al. 2020

Strategies in Trauma and Limb Reconstruction

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Background In this study, the effects of zoledronic acid (ZolA) administered at different times to patients undergoing surgical treatment for hip fracture were investigated. Materials and methods Ninety patients who underwent surgical treatment for osteoporotic (OP) hip fractures between February 2013 and September 2016 in our hospital were included in the study. After surgical treatment, patients were allocated into three groups: group I—patients who had osteosynthesis using proximal femoral nail (PFN) for an intertrochanteric fracture of the femur were given ZolA within 1 week after fracture and before discharge; group II—patients who had osteosynthesis using the PFN for an intertrochanteric fracture of the femur were given ZolA within 1 month after fracture post-discharge; group III—patients in the same age group who had a hemiarthroplasty (HA) for an intertrochanteric fracture of the femur were administered ZolA before discharge. In addition, all patients were given daily oral calcium and vitamin D3. The Radiographic Union Score for Hip (RUSH), Harris Hip Score (HHS), and bone mineral density (BMD) were used at the follow-up as evaluation criteria, and complications were noted. Results There were no significant differences between groups in terms of demographic data and laboratory outcomes ( p > 0.05). Radiographic Union Score for Hip scores were similar between groups I and II ( p > 0.05). Fracture union occurred by the sixth month in all patients whose results were evaluated. No statistically significant difference was found between three groups ( p > 0.05). There was no difference between the three groups in the hip and vertebrae BMD and t scores ( p > 0.05). When t and BMD scores before treatment were compared with those at 1 year after treatment, a benefit from ZolA treatment was observed in all three groups ( p < 0.05). Conclusion This study shows that the timing of ZolA administration has no effect on fracture healing and complication incidence in elderly patients with hip fractures. In addition, ZolA was found to be beneficial in increasing BMD of both femur and vertebra in all groups, but there was no significant difference between the groups. Clinical significance The study demonstrated that ZolA may be used early in the treatment of osteoporotic hip fractures with PFN. How to cite this article Sargin S, Konya MN, Gulcu A, et al. Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures. Strategies Trauma Limb Reconstr 2019;14(3):126–131.

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“…In 2011, Lyles 98 carried out a double-blind placebo-controlled randomized trial, with an average follow-up of almost two years, which indicated a 28% reduction in death due to any cause after the administration of intravenous zoledronic acid in the first three months following a hip fracture. Cengiz 104 found a reduction in mortality after one year of 20.2% in pertrochanteric fractures. It is not clear when the optimum moment for the administration of zoledronic acid is, but it appears that the beneficial effect on mortality is lower if it is administered in the first two weeks after the fracture.…”

Section: Effect Of Osteoprotective Treatments On Mortalitymentioning

confidence: 96%

Efficacy, cost, and aspects to take into account in the treatment of osteoporosis in the elderly

Sáez-López

Etxebarría-Foronda

Lampré³

et al. 2019

Revista Española de Geriatría y Gerontología

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Age is one of the principal risk factors for development of frailty fractures. Age pyramids show a population that is becoming increasingly more elderly, with an increasing incidence of fractures, and the forecasts for the future are truly alarming. Adequate handling of these patients who are especially at risk, at both the preventive and care levels, with a well-defined orthogeriatric model is necessary to respond to this clinical challenge. The objective of this review is to analyze the efficacy of the different strategies for the handling of geriatric patients with fracture risk.

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Effects of Zoledronate on Mortality and Morbidity after Surgical Treatment of Hip Fractures

Cited by 16 publications

References 50 publications

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Effects of Zoledronic Acid Treatment on Fracture Healing, Morbidity and Mortality in Elderly Patients with Osteoporotic Hip Fractures

Efficacy, cost, and aspects to take into account in the treatment of osteoporosis in the elderly

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