Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Assessment and Treatment of Osteoporosis After Hip-Fracture: An Observational Study.
Antonelli, Maria, Einstadter, Douglas, Magrey, Marina N.
Most patients with osteoporosis (OP) are untreated and remain so even after hip fracture. Outcomes following osteoporotic hip fractures are worse among men and non-Caucasians compared to Caucasian women. We hypothesized that screening and treatment of OP after hip fracture remains low in men and non-Caucasian women.
We identified all patients aged >= 65 years old with a primary diagnosis of hip fracture (ICD9-DM code 820.xx) discharged form an urban public hospital between Jan 1, 2000 and Dec. 31, 2010. Patients with active malignancy (one year before or after the fracture), and Paget's disease were excluded. Also, patients were excluded if they had less than two encounters for post-event care at the hospital. Patient charts were reviewed to obtain information on demographics, post- fracture osteoporosis screening status (Dual-energy x-ray absorptiometry (DXA) ordered or resulted), osteoporosis treatment status (prescription for oral bisphosphonates, raloxifene, zoledronic acid, calcitonin or teriparatide), and referral to rheumatology clinic. Data were captured using Research Electronic Data Capture (REDCap). Differences in frequency of patients who had been evaluated by DXA and/or prescribed anti-osteoporotic therapy after hip fractures overall and stratified by sex and race were evaluated using Chi-square tests. The study was approved by our hospital IRB.
There were a total of 597 patients discharged with a primary diagnosis of hip fracture during the study period. After exclusions, 420 patients remained and were included in the analyses. The median age was 80 years (range 65 95), 113 (27%) were men, and 243 were White women (57.9%). Overall, 13.8% of patients were ordered DXA after their hospital discharge, 8.9% of men and 15.6% of women (p = 0.43). A total of 19% received treatment for osteoporosis, and women were nearly 3 times more likely to receive treatment than men (23.1% vs. 8%, p = 0.004). Less than 1% of patients were referred to a Rheumatologist. The rates of DXA, treatment and referral to Rheumatology did not differ by race.
The frequency of osteoporosis screening using DXA scan, and the initiation of osteoporosis treatment was low in all patients after fragility fractures of hip. Women were more likely than men to receive DXA and significantly more likely to receive osteoporosis treatment. While representative of only one hospital, these data suggest that more attention should be paid to possible osteoporosis among elderly patients hospitalized for hip fracture, and especially among men.
To cite this abstract, please use the following information:
Antonelli, Maria, Einstadter, Douglas, Magrey, Marina N.; Assessment and Treatment of Osteoporosis After Hip-Fracture: An Observational Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :870