H. Baharuddin, R. Nasadurai, S. S. Ch'ng, Y. Z. Cheng, D. R. Ramakrishna Rao, P. A. Megat Mohamad Zainuddin, S. Sabir Husin Athar, M. Mohd Zain
2021 Annals of the Rheumatic Diseases  
Background:Hip fractures are associated with significant morbidity, mortality, loss of independence and financial burden.1 There is a positive influence of calcium and vitamin D supplementation on the fracture-healing outcome.2 Recent evidence supports starting bisphosphonate in the acute post-fracture period.3Objectives:To investigate the characteristics and treatment of patients admitted with fragility fracture of the hip.Methods:This is a retrospective study on all patients admitted with
more » ... s admitted with fragility fracture of the hip throughout 2018, included in the hospital registry. Data collected included patients' characteristics, place of falls, types of fracture, in-patient surgical treatment and medical treatment prescribed up until one year follow-up. Outcome of hospitalisation were reported as alive, death and at-own-risk discharge. Continuous and categorical data were described using mean (±SD) and no of patients (%). Comparison of continuous data was performed using student t-test.Results:One-hundred and sixty-seven patients were admitted with fragility fracture of the hip. There were 44 (26.3%) male and 123 (73.7%) female patients, with a mean age of 77.1(±9.8) years. Male patients were significantly younger compared to female patients [73.1(±10.5) years vs 78.5(±9.1) years, p=0.002]. Eighty-six (51.5%) patients were Chinese, followed 57 (34.1%) Malay and 24 (14.4%) Indian patients. Chinese patients were significantly older than Malay patients [80.4(±8.2) years vs 74.6(±9.8) years, p<0.001] and Indian patients [80.4(±8.2) years vs 71.0(±10.5), p<0.001].Most patients, 96 (57.5%) fell within the vicinity of their homes while the other 26 (12.7%) patients fell outside of their home. The place of fall was not documented for 45 (26.9%) patients. The types of fractures were neck of femur in 70 (41.9%), inter-trochanteric fracture in 93 (55.7%) and subtrochanteric in 4 (2.4%) patients.Of 167 patients, 100 (59.9%) patients underwent surgical treatment and 67 (40.1%) patients were treated conservatively. The prescription of calcium and vitamin D was significantly higher in female patients (Table 1). Of 167 patients, 148 (88.6%) were discharged home, 12 (7.2%) patients died during hospital admission and 7 (4.2%) patients opted for at-own-risk discharge.Table 1.Treatment prescribed to patients admitted with fragility fracture of the hip.TreatmentMale, no of patients (%)Female, no of patients (%)p-valueSurgeryYes (n=100)30 (30)70 (70)0.209No (n=67)14 (20.1)53 (79.1)CalciumYes (n=91)18 (19.8)73 (80.2)0.035No (n=76)26 (34.2)50 (65.8)Vitamin DYes (n=88)16 (18.2)72 (81.8)0.011No (n=79)28 (35.4)51 (64.6)BisphosphonateYes (n=13)013 (100)NANo (n=154)44 (28.6)110 (71.4)Conclusion:There was a high proportion of female patients admitted with fragility fracture of the hip. Majority of patients were Chinese, who were significantly older compared to Malay and Indian patients. We found a low prescription of osteoporosis medications for patients following fragility fracture of the hip. The care of osteoporosis can be improved through multidisciplinary approach.References:[1]Schnell S, et al. The 1-Year Mortality of Patients Treated in a Hip Frature Program for Elders. Geriatr Orthop Surg Rehabil, 2010; 1: 6-14.[2]Fischer V, et al. Calcium and Vitamin D in Bone Fracture Healing and Post Traumatic Bone Turnover. European Cells and Materails, 2018; 35: 365-385.[3]Barton DW, et al. Timing of Bisphosphonate Initiation After Fracture: What Does the Data Really Say? Geriatr Orthop Surg Rehabil, 2020; 11; 1-5.Disclosure of Interests:None declared.
doi:10.1136/annrheumdis-2021-eular.4240 fatcat:hufq25i4fzhtfinbo7ajyc4mzu