Factors associated with receiving anti-osteoporosis treatment among older persons with minimal trauma hip fracture presenting to an acute orthogeriatric service

Injury. 2016 Oct;47(10):2149-2154. doi: 10.1016/j.injury.2016.07.034. Epub 2016 Jul 25.

Abstract

Background/aim: The aim of this study was to investigate factors that were associated with receiving anti-osteoporosis treatment (AOT) among patients with minimal trauma hip fracture admitted to an Australian tertiary trauma centre under the Acute Orthogeriatric Service (AOS) over a 6 month period.

Design: Observational study using prospectively collected data.

Methods: Demographic and clinical characteristics of 211 patients were extracted from the local hip fracture registry and electronic medical records. The outcome measure was receipt of AOT before separation from the AOS. Binary logistic regression was used to identify factors independently associated with treatment.

Results: 91 (45%) patients received AOT, including 51 (25.2%) treatment-naive patients. Factors significantly associated with receiving treatment included higher serum vitamin D level (OR 1.44, 95% CI 1.23-1.70, p<0.001) and trochanteric vs. cervical fracture (OR 2.67, 95% CI 1.30-5.49, p=0.007). Living in a residential aged care facility (RACF) prior to the index fracture (OR 0.2, 95% CI 0.08-0.54, p=0.001) and higher American Society of Anaesthesiologists (ASA) physical status score (OR 0.5, 95% CI 0.25-0.98, p=0.04) significantly lowered the likelihood of treatment. Age, gender, cognitive impairment, premorbid walking ability, previous fragility fracture and renal impairment did not correlate with treatment.

Conclusion: A significant proportion (55%) of hip fracture patients did not receive AOT in hospital. The probability of receiving treatment appears to be significantly associated with serum vitamin D level, fracture type, place of residence and comorbidity burden.

Keywords: Antiresorptive treatment; Correlates; Hip fracture; Osteoporosis; Secondary prevention.

Publication types

  • Observational Study

MeSH terms

  • Aged, 80 and over
  • Australia / epidemiology
  • Bone Density Conservation Agents / therapeutic use*
  • Dietary Supplements
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / methods*
  • Health Services for the Aged*
  • Hip Fractures / complications
  • Hip Fractures / physiopathology
  • Hip Fractures / therapy*
  • Humans
  • Male
  • Osteoporosis / physiopathology
  • Osteoporosis / therapy*
  • Prospective Studies
  • Risk Factors
  • Vitamin D / blood
  • Vitamin D / therapeutic use*

Substances

  • Bone Density Conservation Agents
  • Vitamin D