Undertreatment of Osteoporosis Following Hip Fractures in Jeju Cohort Study

Abstract

BackgroundOsteoporosis treatment following hip fracture is well known to not enough. We previously performed intervention study for orthopaedic surgeon's education and reported twofold increase in osteoporosis detection and treatment rate observed between 2005 and 2007. This follow-up observational study was conducted to find out the rate in which a diagnostic workup and treatment for osteoporosis were done in patients with hip fracture.MethodsMedical records and radiographs in patients who were older than 50 years and diagnosed as having femoral neck or intertrochanteric fractures at 8 hospitals in Jeju island, South Korea from 2008 to 2011 were reviewed. The numbers of patients who were studied with bone densitometry and who were treated for osteoporosis after the diagnosis of hip fracture were analyzed.ResultsNine hundred forty five hip fractures (201 in 2008, 257 in 2009, 265 in 2010, and 304 in 2011) occurred in 191 men and 754 women during the study periods. The mean age of the patients was 79.7 years. The mean rate of osteoporosis detection using dual energy X-ray absorptiometry was 36.4% (344/945 hips) (ranged from 24.2% in 2009 to 40.5% in 2011). The mean initiation rate of osteoporosis treatment was 23.1% (218/945 hips) (ranged from 20% in 2009 to 29% in 2008).ConclusionsDetection and treatment rate of osteoporosis following hip fracture during follow-up periods was still not enough. Additional intervention studies are required to further improvement of osteoporosis treatment rates after hip fracture.

The Adequacy of Diagnosis and Treatment for Osteoporosis in Patients with Proximal Humeral Fractures

“…As a result, male osteoporosis is likely to be underestimated. 3 13 18) The current study confirmed that males were more underdiagnosed and undertreated than females for osteoporotic fracture.…”

“…Several reports suggested that awareness of orthopedic surgeon reduces the risk of osteoporotic fracture and education is the way to improve management for osteoporosis. 3 10 23 25) However, public management program could be a possible solution. 5 10 23) Singh et al 5) reported the screening and treatment for osteoporosis reduced the incidence of proximal humeral fracture by the osteoporosis prevention and management program.…”

“… 1) In addition, the risk of additional fracture following osteoporotic fracture increases from 1.5 to 9 fold. 3) The most common site of osteoporotic fracture is spine, followed by hip, forearm, and proximal humerus. 4) Among them, incidence of proximal humeral fracture has increased by 3 fold over 30 years.…”

Matriz de recomendações para farmacoterapia da osteoporose e da osteoartrite: recurso para subsidiar a adaptação de guias de prática clínica

“…Estudos apontam que grande parte da população mundial é acometida por uma delas ou por ambas, principalmente as mulheres pós-menopausa e os idosos acima de 70 anos. Estima-se que uma porcentagem significativa dos acometidos vem a óbito após complicações pós-cirúrgicas ou longos períodos de imobilização (16,17,22,48,49).…”

“…A alteração de perfil populacional ligada ao aumento de idosos vem gerando problemas sociais e econômicos ao idoso e ao Estado. Muitos acometidos pela OA e OP vem a óbito após longos períodos de imobilização ou devido às complicações de cirurgias que visam amenizar sua situação (16,21,22).…”