Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Arabia

Aging Clin Exp Res. 2020 Sep;32(9):1689-1695. doi: 10.1007/s40520-019-01377-2. Epub 2019 Oct 23.

Abstract

Background: Hip fracture is the most clinically devastating and economically important complication of osteoporosis. Pain, suffering, loss of mobility and independence are some of the devastating consequences of hip fractures. The present study aimed to determine the main characteristics and outcomes of patients with osteoporotic hip fracture and treatment gaps at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.

Methods: This is a single-center, retrospective cohort study analyzing charts of patients > 45 years who were admitted for hip fracture secondary to low-grade trauma from 2008 to 2012.

Results: A total of 264 patients (50.4% males and 49.6% females) were included. The most common fracture types were trochanter (49%) and femoral neck (46%). History of falls was documented in 115 (43.6%) patients. Bone mineral density (BMD) was assessed in only 41 (15.5%) patients. Majority underwent surgery (92%). Surgical complications occurred in 15 (5.7%) patients and medical complications in 21 (7.9%) patients. Vitamin D and calcium were the most common medications, but given only to 45 (17%) patients. Bone mineral density (BMD) assessment was significantly more frequent post-surgery than pre-surgery (p = 0.03). Very few patients received osteoporosis-specific therapy. F ollow-up revealed that 62 (23.5%) patients died 1 year after surgery.

Conclusion: These present findings warrant urgent reassessment of clinical care and treatments provided to patients with osteoporotic hip fractures to prevent recurrent fractures. The introduction of Fracture Liaison Service (FLS) in institutions caring for patients with hip fractures as internationally recommended will definitely change the current status of care.

Keywords: Characteristics; Hip Fracture; Osteoporosis; Outcome and mortality.

MeSH terms

  • Bone Density
  • Female
  • Hip Fractures* / epidemiology
  • Hip Fractures* / surgery
  • Humans
  • Male
  • Middle Aged
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / therapy
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Tertiary Care Centers