Endocrine Abstracts

Background

Most post-osteoporotic fracture patients do not receive osteoporosis treatment, although it reduces risks for additional fractures. This retrospective, observational study reviewed osteoporosis evaluation and treatment following typical osteoporotic fractures.

Methods

We identified patients with hip, vertebral, humerus or radius fractures, examined in Meir Medical Center, January-December 2017. Exclusion criteria were: not a Clalit Health Services member, high energy or pathologic fracture, or 30-day post-operative mortality. Primary endpoint was osteoporosis drugs issued within 12-months of fracture. Secondary endpoints were bone density testing and mortality.

Results

Of 928 patients diagnosed, 346 (37%) were excluded. 582 (78.6 ± 11.1 years-of-age, 75.8% women) were included: 321 (55.5%) hip, 84 (14.1%) humerus, 33 (5.6%) vertebra, 144 (24.7%) radius. Hip fracture patients were older, with more previous fractures. Osteoporosis drugs were issued to 26.5%; humerus fracture received the least (21.4%) and vertebral fracture, the most (30.3%), P = 0.51. Treatment related to age, gender or previous fracture, was similar. Bone density testing was done in 23.2% of patients, with vertebra (39.4%) and radius (34%) the most. One-year mortality after hip fracture was 12.1%, with humerus (3.6%), vertebral (3%) and radius (1.4%) (P = 0.0). Logistic regression demonstrated that previous treatment (OR = 7.4, 95% CI 3.6–15.2), bone density testing (OR = 4.4, 95% CI 2.6–7.4) and endocrinology visit (OR = 2.6, 95% CI = 1.4–4.6) were the most significant discriminating factors associated with osteoporosis treatment.

Conclusions

Fewer than one-third of patients received pharmacotherapy within a year post-fracture. Since pharmacotherapy reduces future fractures and mortality, we encourage medical staff, including orthopedic surgeons, rehabilitation team and general practitioners to increase awareness of their importance.