Emerging trends in hospitalisation for fragility fractures in Ireland

Osteoporosis and sarcopenia are common in older adults. Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone fractures can result in changes in posture, pain, the need for surgical repair and functional impairment. Sarcopenia is the progressive and generalized loss of skeletal muscle mass, strength and/or physical performance. Older adults with sarcopenia experience increased risk of frailty, disability, hospitalizations, mortality, and a reduced quality of life. In this narrative review we provide guidance regarding the prevention of both osteoporosis and sarcopenia, including interventions that prevent both conditions from occurring, recommended screening and treatment to prevent progression.

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“…Common fracture sites are the hip, wrist, spine, pelvis and upper arm. Almost one third of fractures occur in older men 5 …”

Section: Osteoporosismentioning

confidence: 99%

The prevention of osteoporosis and sarcopenia in older adults

Coll

Phu

Hajjar

et al. 2021

J American Geriatrics Society

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“…Unfortunately, we do not have clinical information on the presence or absence of back pain or other symptoms in this dataset. These results suggest the spine is the commonest site of fracture in this population, which is underrepresented in published data for our country [29,33]. 70% of people in this study did not have a DXA T-score below the osteoporosis threshold.…”

Section: Discussionmentioning

confidence: 55%

“…Reasons include under-representation, under-diagnosis and limited data from non-hospital settings [29,[32][33][34]. Reports suggest hospital length of stay is similar to hip fractures [33], while others show VF are common when imaging studies are systematically evaluated [29,34]. Our experience suggests the prevalence and importance of VF are underappreciated by patients, medical staff, healthcare managers and government.…”

Section: Introductionmentioning

confidence: 87%

“…Recent publications on the prevalence, incidence and impact of VF in Ireland highlight a paucity of studies [29,32]. Reasons include under-representation, under-diagnosis and limited data from non-hospital settings [29,[32][33][34]. Reports suggest hospital length of stay is similar to hip fractures [33], while others show VF are common when imaging studies are systematically evaluated [29,34].…”

Section: Introductionmentioning

confidence: 99%

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Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

et al. 2021

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Osteoporosis is an important global health problem resulting in fragility fractures. The vertebrae are the commonest site of fracture resulting in extreme illness burden, and having the highest associated mortality. International studies show that vertebral fractures (VF) increase in prevalence with age, similarly in men and women, but differ across different regions of the world. Ireland has one of the highest rates of hip fracture in the world but data on vertebral fractures are limited. In this study we examined the prevalence of VF and associated major risk factors, using a sample of subjects who underwent vertebral fracture assessment (VFA) performed on 2 dual-energy X-ray absorptiometry (DXA) machines. A total of 1296 subjects aged 40 years and older had a valid VFA report and DXA information available, including 254 men and 1042 women. Subjects had a mean age of 70 years, 805 (62%) had prior fractures, mean spine T-score was − 1.4 and mean total hip T-scores was − 1.2, while mean FRAX scores were 15.4% and 4.8% for major osteoporotic fracture and hip fracture, respectively. Although 95 (7%) had a known VF prior to scanning, 283 (22%) patients had at least 1 VF on their scan: 161 had 1, 61 had 2, and 61 had 3 or more. The prevalence of VF increased with age from 11.5% in those aged 40–49 years to > 33% among those aged ≥ 80 years. Both men and women with VF had significantly lower BMD at each measured site, and significantly higher FRAX scores, P < 0.01. These data suggest VF are common in high risk populations, particularly older men and women with low BMD, previous fractures, and at high risk of fracture. Urgent attention is needed to examine effective ways to identify those at risk and to reduce the burden of VF.

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“…It was estimated to cost the Irish health service approximately €45 million in 2018 [ 2 ]. The financial cost associated with hip fractures in Ireland is estimated to increase to approximately €162 million per year by 2046 [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Non-Simultaneous Contralateral Second Hip Fractures: A Single-Center Irish Study

Nolan¹,

Tiedt²,

Ellanti³

et al. 2020

Cureus

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Introduction Hip fractures are a significant cause of morbidity and mortality in the elderly and are also associated with increased healthcare costs. A second contralateral hip fracture can lead to even more complications and healthcare costs. A significant proportion of the Irish hip fracture population does not receive a bone health assessment or falls specialist assessment to reduce the risk of future falls and fractures. This study aimed to analyze the incidence of a non-simultaneous contralateral hip fracture in an Irish population. Methods We retrospectively analyzed 1,344 patients presenting to our institution with a hip fracture from January 2007 to June 2019. Patients aged ≥ 60 years old presenting with a neck of femur or pertrochanteric fracture were included in our study. We excluded patients who had sub-trochanteric and femoral shaft fractures, high energy fractures, and pathological fractures. We also excluded patients less than 60 years old, as fractures in these younger patients may not be purely related to osteoporosis. Results A total of 1,099 hip fractures meeting the inclusion criteria were treated at our unit during the designated time period. A total of 102 (9.3%) patients experienced a second hip fracture. The mean age at first presentation in our institution was 78.5 years old, with a mean time between first and second hip fractures of 37.2 months. Conclusions Patients presenting with a second hip fracture may represent 9.3% of the Irish hip fracture population. We hope that this study will help inform on the rate of second hip fractures in an Irish population and help advocate for improved resources and implementation of secondary prevention strategies.

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Emerging trends in hospitalisation for fragility fractures in Ireland

Abstract: There has been a significant increase in the number of fracture admissions in Irish men and women over the past 15 years. This is projected to increase further over the next three decades which will place a significant burden on the Irish healthcare system.

Cited by 31 publications

References 31 publications

The prevention of osteoporosis and sarcopenia in older adults

The prevention of osteoporosis and sarcopenia in older adults

Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

Incidence of Non-Simultaneous Contralateral Second Hip Fractures: A Single-Center Irish Study

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