Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
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 1st of January of 2000 and 31st 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).
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.
To cite this abstract in AMA style:González-Giménez X, Gomez-Vaquero C, Valencia-Muntala L, Zacarias A, Martin I, Tramunt C, Redondo A. Hip Fracture Incidence in a Teaching Hospital: Intervention for the Prevention of Second Hip Fracture [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/hip-fracture-incidence-in-a-teaching-hospital-intervention-for-the-prevention-of-second-hip-fracture/. Accessed December 5, 2020.
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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/