Background Hip fracture has great impact on morbi-mortality, but a large percentage of patients do not receive treatment.
Objectives To know the characteristics of patients whith hip fracture and its evolution in the first 6 months.
Methods A prospective, 6-month follow-up study of patients over 60 years old admitted for hip fracture, evaluated in a local FLS. At 3 months after discharge, patients are evaluated for: epidemiological data, fracture income (days of admission, prior and discharge of osteoporosis (OP) drugs, general biochemistry and vitamin D), OP records and possible diseases or osteopenizing drugs, lumbar spine and hip Bone densitometry (BMD) lateral dorsal and lumbar spine radiology and the treatment was decided. The electronic history before and after 6 months of the fracture were reviewed.
Results Of 152 patients >60 years old, admitted in 2016 due hip fracture, 77 (51%) were during the first 6 months. However, radiology or BMD data were not available for 30 (39%) patients, 16 (21%) for death and 14 (18%) for loss of follow-up. Mean BMI was 26.02±6.2. The mean age of menopause was 49±5 years. 1% of the patients received corticosteroids and 2% of patients an osteopenizing disease (COPD) was found. Mean time of admission was 7.57±2.51 days. In 3% of the patients, before the fracture were receiving OP treatment, which continued to discharge. The mean level of calcium, phosphorus and alkaline phosphatase was normal. However, the mean level of 25OH vitamin D was 13.55±8.63 ng/ml (median: 12 ng/ml, range: <4 to 29 ng/ml).
In 11 of the 27 (41%) patients, in whom radiology was available, the presence of vertebral fracture was demonstrated. The mean T-score for lumbar BMD was 1.8±1.65 DE (32%: the result was normal, 36% osteopenia, 32% OP), femoral neck 2.59±0.77 DE (27%: osteopenia, 77% OP) and in total hip: 2.56±0.86 DE (56%:osteopenia and 44% OPand In Ward of 3.2 DE. 100% of patients evaluated in Rheumatology, initiated treatment for OP: zoledronate: 40%, alendronate: 20%, denosumab: 25%, PTH: 15%.
Conclusions In patients with hip fracture: 1) Mortality is high (21%), in the first 6 months after fracture. 2) The prevalence of vertebral fracture is 40%. 3) It is accompanied by very low blood levels of vitamin D. 4) In a high percentage the result of BMD is normal or osteopenia. 5) A minimum number of patients receive specific treatment for osteoporosis after fracture. 6) Evaluation in a FLS, ensures the evaluation and treatment of patients.
Acknowledgements The study was supported by a research grant from the Asociaciόn para la Investigaciόn en Reumatología de la Marina Baixa (AIREMB).
Disclosure of Interest None declared