Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Ar
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ORIGINAL ARTICLE
Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Arabia Yousef Al Saleh1,2,3,5 · Mohammed E. El Seid3 · Mead E. Ruhaiyem2 · Fatimah Al Sayed2 · Abeer Alkhairy2 · Sarah Al Zaid2 · Osama Al Sayed2 · Soad Salih4 · Nasser M. Al‑Daghri5 Received: 19 June 2019 / Accepted: 5 October 2019 © Springer Nature Switzerland AG 2019
Abstract Background 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. Methods 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. Results 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. Conclusion 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. Keywords Hip Fracture · Osteoporosis · Characteristics · Outcome and mortality
Introduction
* Yousef Al Saleh [email protected] 1
College of Medicine, King Saud Bin Abdulaziz University and King Abdullah International Medical Research Center, Riyadh 11425, Saudi Arabia
2
King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia
3
Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
4
King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
5
Chair for Chronic Diseases, College of Science, King Saud University, Riyadh, Saudi Arabia
Osteoporosis is a systemic disorder characterized by decreased bone mass with increased bone fragility resulting in great susceptibility to fractures [1]. It is well known that hip fracture is the most severe and important complication of osteoporosis with physical, psychological and econom
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