College of Medicine, King Saud Bin Abdulaziz University and King Abdullah International Medical Research Center, Riyadh, 11425, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, 11426, Saudi Arabia.
Aging Clin Exp Res. 2020 Sep;32(9):1689-1695. doi: 10.1007/s40520-019-01377-2. Epub 2019 Oct 23.
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.
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.
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.
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.
髋部骨折是骨质疏松症最具临床破坏性和最重要的并发症。疼痛、痛苦、丧失活动能力和独立性是髋部骨折的一些破坏性后果。本研究旨在确定沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城（KAMC）骨质疏松性髋部骨折患者的主要特征和结局以及治疗差距。
这是一项单中心、回顾性队列研究，分析了 2008 年至 2012 年因低级别创伤住院治疗的>45 岁髋部骨折继发骨质疏松症患者的病历。
共纳入 264 例患者（50.4%为男性，49.6%为女性）。最常见的骨折类型是转子间（49%）和股骨颈（46%）。115 例（43.6%）患者有跌倒史。仅 41 例（15.5%）患者评估了骨密度（BMD）。大多数患者接受了手术（92%）。15 例（5.7%）患者发生手术并发症，21 例（7.9%）患者发生医疗并发症。维生素 D 和钙是最常用的药物，但仅给 45 例（17%）患者使用。手术后 BMD 评估明显比手术前更频繁（p=0.03）。极少数患者接受骨质疏松症特异性治疗。随访发现，术后 1 年有 62 例（23.5%）患者死亡。
这些发现表明，迫切需要重新评估为骨质疏松性髋部骨折患者提供的临床护理和治疗，以防止再次骨折。按照国际建议，在为髋部骨折患者提供护理的机构中引入骨折联络服务（FLS）肯定会改变当前的护理状况。
