Abstract
A positive history of fractures in older patients with hip fracture is common. We determined the risk factors associated with a positive history of fractures and the profile of care in hip fracture patients. In the Break Study, we enrolled 1249 women aged ≥60 years, seeking care for a hip fracture. Baseline information included age, body mass index, lifestyle (smoking habit, alcohol consumption), patient’s history of fracture after the age of 50 years, family history of fragility fracture and health status (presence of comorbidity, use of specific drugs, pre-fracture walking ability, type of fracture, time to surgery, type of surgery, osteoporosis treatment). In the multivariable model age, smoking, family history, treatment with antiplatelet, anticoagulants and anticonvulsants, were significant predictors of a positive history of fracture. More than 70% of patients underwent surgery more than 48 hours after admission. About 50% were discharged with a treatment for osteoporosis, but more than 30% only with calcium and vitamin D. In conclusion, factors associated with a positive history of fracture are the traditional risk factors, suggesting that they continue to have a negative impact on health even at older ages. Selected drugs, such as antiplatelet and anticoagulants, deserve further consideration as significant factors associated with fractures. Given that delay in surgery is a major cause of mortality and disability, while treatment for osteoporosis decreases significantly the risk of recurrent fractures and disability, interventions to modify these patterns of care are urgently needed.
Similar content being viewed by others
References
Cummings-Vaughn LA, Gammack JK. Falls, osteoporosis, and hip fractures. Med Clin North Am 2011; 95: 495–506.
Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985; 7: 178–208.
Kanis JA, Johnell O, De Laet C et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone 2004; 35: 375–82.
Scottish Intercollegiate Guidelines Network (SIGN). (2002). Prevention and Management of Hip Fracture in Older People. SIGN Publication No. 56. ISBN 1899893 72 5.
Chilov MN, Cameron ID, March LM. Evidence-based guidelines for fixing broken hips: an update. MJA 2003; 179: 489–93.
Maggi S, Siviero P, Wetle T, Besdine RW, Saugo M, Crepaldi G, for the Hip Fracture Study Group: A multicenter survey on profile of care for hip fracture: predictors of mortality and disability. Osteoporos Int 2010; 21: 223–31.
Häkkinen A, Heinonen M, Kautiainen H et al. Effect of cognitive impairment on basic activities of daily living in hip fracture patients: a 1-year follow-up. Aging Clin Exp Res 2007; 19: 139–44.
Shoham Y, Peled R, Atar D et al. Emergency room consultation policy prevents surgery delay in elderly patients with hip fractures. Harefuah 2005; 144: 700–2, 751.
Elliott J, Beringer T, Kee F et al. Predicting survival after treatment for fracture of the proximal femur and the effect of delays to surgery. J Clin Epidemiol 2003; 56: 788–95.
Friedman SM, Mendelson DA, Kates SF, McCann RM. Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc 2008; 56: 1349–56.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
An erratum to this article is available at http://dx.doi.org/10.1007/BF03324970.
Rights and permissions
About this article
Cite this article
Maggi, S., Siviero, P., Gonnelli, S. et al. The burden of previous fractures in hip fracture patients. The Break Study. Aging Clin Exp Res 23, 183–186 (2011). https://doi.org/10.1007/BF03324958
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03324958