Burden of screening and treatment of bone health markers amongst elderly patients with proximal femur fractures.

INTRODUCTION

This study aims to quantify changes in the burden of screening for osteoporosis and vitamin D deficiency (VDD) amongst elderly patients treated with proximal femur fracture repair (PFFR).

METHODS

Data collection and analysis was performed via the TriNetX HCO group network titled Research. Patients aged 65 and older who underwent PFFR were included based on CPT codes. Rates of preexisting diagnoses of VDD and/or osteoporosis, and first-time diagnoses of VDD or osteoporosis at 1 month, 6 months, and 1 year following PFFR between 2004 and 2024 were explored. Patient demographics and comorbidity data were compared across patient cohorts using chi-square tests for categorical variables, independent samples t-tests for continuous variables. Standardized differences were used to calculate the effect size.

RESULTS

PFFRs registered in TriNetX have increased from 2004 to 2024 (Table 1). Those patients who underwent PFFR without prior history of VDD and/or osteoporosis ranged from 74.60% in 2004 to 49.83% in 2024. Conversely, patients with a prior history of documented VDD and/or osteoporosis ranged from 25.4% in 2004 to 50.1% in 2024. The percent risk of a first-time diagnosis of osteoporosis at 1 month, 6 months, and 1 year in the overall cohort were 3.7%, 8.6%, and 10.3%, respectively. The percent risk of a first-time diagnosis of VDD at 1 month, 6 months, and 1 year in the overall cohort were 2.1%, 4.4%, and 5.6%, respectively.

CONCLUSION

The burden of screening for markers of bone health and subsequent treatment in at risk patients has increased over time. Rates of first-time diagnoses of osteoporosis or VDD after PFFR represent a current treatment burden of approximately 10% and 5% of this population at 1 year, respectively. This number may underrepresent the true burden of disease, highlighting the necessity of screening protocols targeting this population.