The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study

Tarantino, Umberto; Capone, Antonio; Planta, Marco; D’Arienzo, Michele; Mauro, Giulia Letizia; Impagliazzo, A.; Formica, Alessandro; Pallotta, Francesco; Patella, Vittorio; Spinarelli, Antonio; Pazzaglia, U. E.; Zarattini, Guido; Roselli, Mauro; Montanari, Giuseppina; Sessa, Giuseppe; Privitera, Marco; Verdoia, C.; Corradini, C.; Feola, Maurizio; Padolino, Antonio; Saturnino, Luca; Scialdoni, Alessandro; Rao, Cecilia; Iolascon, Giovanni; Brandi, Maria Luisa; Piscitelli, Prisco

doi:10.1186/ar3213

Cited by 74 publications

(49 citation statements)

References 30 publications

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“…In the present analysis, we report an increasing incidence of both major consecutive women and men aged 50 years and older and presenting to the emergency ward of participating hospitals with a fragility fracture [34], virtually all hip fractures, approximately half of proximal humerus fractures, one third of distal radius fractures, and one fourth of clinical spine fractures were hospitalized in Switzerland [3]. These observations are broadly consistent with reports from other countries [35].…”

Section: Cost Of Hospitalizationssupporting

confidence: 88%

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

et al. 2011

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Mini-AbstractIn Switzerland, the number, incidence, and cost of acute hospitalizations for major osteoporotic fractures and major cardiovascular events increased in both women and men between 2000 and 2008, although the mean length of stay was significantly reduced. Similar trend patterns were observed for hip fractures and strokes (decrease) and non-hip fractures and acute myocardial infarctions (increase). Methods : Trends in the number, age-standardized incidence, mean length of stay and cost of hospitalized MOF (hip, clinical spine, distal radius, and proximal humerus), major cardiovascular events (MCE: acute myocardial infarction, stroke, heart failure), chronic obstructive pulmonary disease (COPD), and breast carcinoma were compared in women and men aged ≥45 years, based on data from the Swiss Federal Statistical Office hospital database and population statistics.Results : Between 2000 and 2008, the age-standardized incidence of acute hospitalizations for MOF increased by 3.4% in women and 0.3% in men. In both sexes, a significant decrease in hip fractures (-15.0% and -11.0%) was compensated by a concomitant, significant increase in non-hip fractures (+24.8% and +13.8%).Similarly, the incidence of acute hospitalizations for MCE increased by 4.4% in women and 8.2% in men, as an aggregated result from significantly increasing acute myocardial infarctions and significantly decreasing strokes. While the mean length of stay in the acute inpatient setting decreased almost linearly between year 2000 and 3 2008 in all indications, the inpatient costs increased significantly (p<0.001) for MOF (+30.1%, +42.7%) and MCE (+22.6%, +47.1%) in women and men, respectively. In women in 2008, the cost of acute hospitalizations was more than threefold higher for MOF than for COPD and breast cancer and 1.5 fold higher than for any MCE. In men it was comparable to that of COPD, acute myocardial infarction, and heart failure.Conclusions : In conclusion, between year 2000 and 2008, the burden of hospitalized osteoporotic fractures to the Swiss healthcare system has continued to increase in both sexes. In women, this burden was significantly higher than that of major cardiovascular events and the gap between both disease groups widened over time.

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Section: Cost Of Hospitalizationssupporting

confidence: 88%

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

et al. 2011

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“…The annual incidence of the overall most common fragility fractures (hip, wrist, vertebral, humeral, and ankle fractures) per 100 inhabitants has been estimated up to 1.53 in men aged older than 65 years and up to 3.94 in women of the same age group. The incidence per 100 inhabitants reached 2.35 and 4.67 in men and women aged older than 75 years, respectively (with women aged older than 75 years the age group in which the highest number of fragility fractures was detected); and if the current trends continue, this number is expected to triple in the next 50 years (5). The medical and social cost of hip fractures in Italy is about 1 billion euros, most of which for surgery and rehabilitation (6).…”

Section: Introductionmentioning

confidence: 99%

The contribution of cortical and trabecular tissues to bone strength: insights from denosumab studies

Iolascon¹,

Napolano²,

Gioia³

et al. 2013

CCMBM

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SummaryAll materials undergo an aging process which is characterized essentially by changes of the rigidity (stiffness), of the ability to absorb the stresses (toughness) and then ultimately in the mechanical resistance (strength). Both cortical and trabecular bone undergo a continuous process of structural remodeling with the main aim to preserve their biomechanical properties. An imbalance in this process, which promotes bone resorption, results in a quantitative loss of bone tissue and in a qualitative alteration of the skeletal microarchitecture, as you can see in osteoporosis, rheumatoid arthritis or bone metastases. Cortical component has a prominent role on strength therefore loss of cortical bone that is prevalent in elderly may explain the higher frequency of fractures of bones composed mainly of cortical bone such as the proximal femur. Remodeling inhibition with denosumab improved structural strength without altering material properties, that can be primarily explained by the combined effects of increased trabecular and cortical bone mass, and reductions in trabecular eroded surfaces and particularly cortical porosity. Denosumab for its mechanism of action and pharmacokinetics results in a significant, early and continued increase in BMD with enhanced bone strength improving both cortical and trabecular bone.

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“…Fragility fractures are underestimated and this is often due to the underdiagnosis of osteoporosis in patients at higher risk, resulting in the undertreatment of this condition and consequently in an additional risk of fractures (2). Osteoporosis treatment involves several therapeutic options, including long-term drug therapy (3).…”

Section: Introductionmentioning

confidence: 99%

Rates and reasons for lack of persistence with anti-osteoporotic drugs: analysis of the Campania region database

Iolascon

Gimigliano

Moretti

et al. 2016

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SummarySubjects with chronic diseases are more likely to be nonpersistent to pharmacological treatment. Lack of persistence is common among subjects using oral anti-osteoporotic drugs, and leads to increased risk of fragility fracture. The aim of our retrospective study is to analyze the rates and reasons for discontinuation of anti-osteoporotic drugs in the Campania Region. Subjects aged over 40 years were included if they had received at least one prescription for any anti-osteoporotic drugs. Data were obtained from an administrative database of regional data on outpatient drug prescriptions reimbursed by the National Health Service. Patients were followed until the discontinuation of anti-osteoporotic therapy or until the end of the observation period. A total of 30,048 were incident users of anti-osteoporotic drugs: 28,317 (94.2%) females. The mean age of the cohort was 69.0±10.0 years. Weekly bisphosphonates (51.1%) were the most commonly prescribed drugs. In the overall population, persistence rates were 34.8% after 6 months and 13.4% at one year. A multivariate Cox proportional hazard analysis showed that daily regimen (HR 1.9) treatments remained at higher risk of early discontinuation compared to weekly regimen therapies.Our data showed that the persistence to osteoporosis therapy is significantly worse than reported in literature.

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The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study

Cited by 74 publications

References 30 publications

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

The contribution of cortical and trabecular tissues to bone strength: insights from denosumab studies

Rates and reasons for lack of persistence with anti-osteoporotic drugs: analysis of the Campania region database

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