Background/Purpose: Since March 2009, every patient who was admitted in the Orthopaedic Surgery Department for a hip fracture (HF) was evaluated during the admission period by a Hip Fracture Unit (HFU). The assessment included the risk of fracture and diseases related to bone fragility other than osteoporosis. In the discharge report, a mention of the risk of fracture and the previous treatments as well as a treatment recommendation were done. An electronic prescription was made for the advised treatment. An appointment in the next 3 months in the HFU outpatient clinics was set to monitor treatment adherence.

Purpose: To evaluate the incidence of HF in an 18 year period and the efficacy of the intervention made by the HFU in the incidence of second hip fracture (SHF).

Methods: Methods: From the area hospital discharge database of a teaching hospital between 1^st of January of 2000 and 31^st of December of 2017, the admissions for HF and SHF from the patients that lived in the reference area of the hospital were analyzed. A SHF was defined as the contralateral HF to a previous HF. SHF were only included if data from the previous HF was available. Two periods of study about 9 years long each were defined: a control period and an intervention period, before and after 1st of March 2009, the date when HFU started working. The rest of the items of the study were: sex, age, age at the time of HF and time of follow-up until SHF or the end of the study. Data about the reference population were accessible in the website of IDESCAT (Catalonian Institute of Statistics: http://www.idescat.cat/pub/). During the period of study, the subjects older than 65 years increased a 33%, from 48,606 to 64,396 inhabitants (31% women, 35% men).

Results: Results: During the 18 years of the study, there were 2,625 patients > 65 years old admitted because of a HF (1,952 women and 673 men, ratio 2.9:1). The annual incidence of HF in this period was 257 fractures for 100,000 inhabitants and year (x 100 K/y) (333 x 100 K/y in women and 154 x 100 K/y in men).

The absolute number of hip fractures increased during the study period in women and in men with significant statistical difference (p < 0.05 women, p < 0.001 men). The incidence of HF has been stable in women and has increased in men (p < 0.05).

The patients included in both study periods were different in age and sex: in the intervention period there were more men (29% vs. 26%, p < 0.05) and they were older (83 ± 7 years, p < 0.001).

In the study period, 133 SHF were admitted (5.06% of fractures). There were 87 SHF which took place in the 1,143 patients who presented a HF during the control period (7.61%) and 46 in the 1,313 (3.50%) during the intervention period (p: ns). There were 244 patients who died during the admission and were excluded from the SHF study.

There were no differences in sex between patients who presented a SHF or those who did not. Patients with SHF were older than patients without SHF (86 ± 7 years vs. 83 ± 7 years, p < 0.001).

Conclusion:

Conclusions: In a teaching hospital, the incidence of HF has remained stable in the last 18 years in women and has increased in men. After 9 years of a HFU intervention, we could not demonstrate a reduction in the incidence of SHF.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/hip-fracture-incidence-in-a-teaching-hospital-intervention-for-the-prevention-of-second-hip-fracture/