Multidisciplinary osteoporosis management of post low-energy trauma hip-fracture patients

2012 ◽  
Vol 25 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Nicole Skorupski ◽  
Ivy M. Alexander
Keyword(s):  
Hip Fracture ◽  
Low Energy ◽  
Osteoporosis Management

scholarly journals Predictors of In-Hospital Ambulatory Status Following Low-Energy Hip Fracture Surgery

2019 ◽  
Vol 10 ◽  
pp. 215145931881482 ◽  
Author(s):  
Jordan C. Villa ◽  
Joseph Koressel ◽  
Jelle P. van der List ◽  
Matthew Cohn ◽  
David S. Wellman ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hip Fracture ◽  
Peptic Ulcer Disease ◽  
Median Time ◽  
Low Energy ◽  
Ulcer Disease ◽  
Time To Surgery ◽  
Ambulatory Status ◽  
Delayed Time

Introduction: Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. Purposes: To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery. Methods: This is a retrospective analysis of 463 geriatric patients who required HF surgery at a metropolitan level-1 trauma center. The outcomes were time to transfer (out of bed to chair) and time to walk. Results: Three hundred ninety-two (84.7%) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range: 24.7-53.69 hours), while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range: 40.72-74.56 hours). Preinjury ambulators with aids (hazard ratio [HR]: 0.70, confidence interval [CI]: 0.50-0.99), age >80 years (HR: 0.66, CI: 0.52-0.84), peptic ulcer disease (HR: 0.57, CI: 0.57-0.82), depression (HR: 0.66, CI: 0.49- 0.89), time to surgery >24 hours (HR: 0.77, CI: 0.61-0.98), and surgery on Friday (HR: 0.73, CI: 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR: 0.74, CI: 0.56-0.98), females (HR: 0.67, CI: 0.48-0.94), peptic ulcer disease (HR: 0.23, CI: 0.84-0.66), and depression (HR: 0.51, CI: 0.33-0.77). Conclusions: Operative predictors of delayed time to transfer were surgery on Friday and time to surgery >24 hours after admission. Depression is associated with delayed time to transfer and time to walk. These data suggest that is important to perform surgeries within 24 hours of admission identify deficiencies in care during the weekends, and create rehabilitation programs specific for patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient care costs, and better long-term functional outcomes.

scholarly journals SOSTOYaNIE MINERAL'NOY PLOTNOSTI KOSTNOY TKANI U ZhENShchIN, PERENESShIKh MALOTRAVMATIChNYE PERELOMY V VOZRASTE 50 LET I STARShE

2012 ◽  
Vol 15 (2) ◽  
pp. 9-12
Author(s):  
O V Dobrovol'skaya ◽  
N V Demin ◽  
N V Toroptsova
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
High Frequency ◽  
Low Energy ◽  
Mineral Density ◽  
Wrist Fractures ◽  
History Of ◽  
The Mean

This study was aimed to evaluate the bone mineral density (BMD) in women at the age of 50 years and older with the his tory of fracture(s) after a low-energy trauma. For this purpose the osteodensitometry of three areas was performed in 173 women with different low-traumatic fractures. Osteoporosis and osteopenia were found in 77% and 21% of patients respectively. Osteoporosis at least in one of three areas was revealed in 80% of women with hip fracture, in 77% of women with wrist fractures, in 73% of patients with humeral fractures, in 86% women after vertebral fractures and in 62% of patients with ankle fractures. Moreover, in these subgroups the osteoporosis in two areas of three was found in 38%, 23%, 30%, 33% and 24% of cases respectively. Osteoporosis in all three areas was detected more frequently in women with wrist fractures (in 39% of cases). The high frequency of osteoporosis in women with the history of low-traumatic fractures argues the need of an adequate antiosteoporotic treatment without mandatory verification of the reduced BMD by the mean of the osteodensitometry.

scholarly journals 63 Impact of an Orthogeriatric Service on Osteoporosis Management in HIP Fracture Patients

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Homaira Amini ◽  
Kevin Ong ◽  
Edward Strivens
Keyword(s):  
Vitamin D ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Odds Ratio ◽  
Diagnosis Of Osteoporosis ◽  
Osteoporosis Management ◽  
Minimal Trauma ◽  
Tertiary Teaching ◽  
Before And After ◽  
New Diagnosis

Abstract Background Osteoporosis which is now treatable is the major risk factor for hip fractures in the elderly. Having a hip fracture increases morbidity and mortality. Hip fractures are costly. Incidence increases with age. Aims To examine how introduction of an orthogeriatric service (OGS) improves osteoporosis management. Method A dedicated OGS was established in the orthopaedic unit in an Australian tertiary teaching hospital in July 2014. Retrospective analyses were undertaken to compare osteoporosis diagnosis and treatment rates in patients ≥ 65 years old presenting with minimal trauma hip fractures (MTHF) before and after the OGS was established. Results 1. 108 MTHF (mean age 81 years) and 107 MTHF (mean age 82 years) were admitted in 2014 respectively before and after the OGS was established. 2. New osteoporosis diagnoses increased by 27%, new calcium &/or vitamin D prescription increased by 17% and new antiresorptive treatment increased by 30%, after the OGS was established. 3. The odds ratio for receiving a new diagnosis of osteoporosis post MTHF with the OGS compared to pre-OGS was 4.4 (2.1 – 9.0), p<0.0001. 4. The odds ratio for initiating new antiresorptive treatment post fractured NOF with OGS compared to pre-OGS was 6.2 (3.0 – 12.7), p<0.0001. 5. Rates of new diagnoses of osteoporosis and initiation of antiresorptive treatments with the OGS were not affected by age or gender. Conclusion 1. Introduction of a dedicated OGS improved osteoporosis diagnoses and initiation of antiresorptive treatments. 2. Patients who received a new diagnosis of osteoporosis and/or started on antiresorptive treatment were also likely to be prescribed calcium and/or vitamin D supplements as well. 3. There did not appear to be any age or gender bias towards giving more new diagnoses of osteoporosis and/or more new antiresorptive treatments with a dedicated OGS. 4. These results may be useful for benchmarking and comparison purposes.

scholarly journals Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA)

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Sanjit R. Konda ◽  
Hesham Saleh ◽  
Ariana Lott ◽  
Kenneth A. Egol
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Discharge Planning ◽  
Risk Index ◽  
Low Energy ◽  
Minimal Risk ◽  
Middle Aged ◽  
Readmission Rates ◽  
Risk Patients ◽  
Discharge Location

Patterns of discharge location may be evident based on the “sickness” profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization. On initial evaluation in the Emergency Department, each patient’s age, comorbidities, injury severity, and functional status were utilized to calculate a STTGMA score. Discharge location was recorded with the primary outcome measure of an unsuccessful discharge being readmission within 30 days. Patients were risk stratified into minimal-, low-, moderate-, and high-risk STTGMA cohorts. A p-value of <0.05 was considered significant for all statistical tests. 408 low-energy hip fractures were enrolled in the study with a mean age of 81.3±10.6 years. There were 214 (52.5%) intertrochanteric fractures, 167 (40.9%) femoral neck fractures, and 27 (6.6%) subtrochanteric femur fractures. There was no difference in readmission rates within STTGMA risk cohorts with respect to discharge location; however, among individual discharge locations there was significant variation in readmission rates when patients were risk stratified. Overall, STTGMA risk cohorts appeared to adequately risk-stratify readmission with 3.5% of minimal-risk patients experiencing readmission compared to 24.5% of moderate-risk patients. Specific cohorts deemed high-risk for readmission were adequately identified. The STTGMA tool allows for prediction of unfavorable discharge location in hip fracture patients. Based on observations made via the STTGMA tool, improvements in discharge planning can be undertaken to increase home discharge and to more closely track “high-risk” discharges to help prevent readmissions.

scholarly journals Long-term functional outcome after a low-energy hip fracture in elderly patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Stijn G. C. J. de Joode ◽  
Pishtiwan H. S. Kalmet ◽  
Audrey A. A. Fiddelers ◽  
Martijn Poeze ◽  
Taco J. Blokhuis
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Low Energy

Are Low-Energy Open Ankle Fractures in the Elderly the New Geriatric Hip Fracture?

2015 ◽  
Vol 54 (2) ◽  
pp. 203-206 ◽  
Author(s):  
William P. Toole ◽  
Mark Elliott ◽  
David Hankins ◽  
Corey Rosenbaum ◽  
Anthony Harris ◽  
...  
Keyword(s):  
Hip Fracture ◽  
The Elderly ◽  
Low Energy ◽  
Ankle Fractures ◽  
Geriatric Hip Fracture

scholarly journals Vertebral fractures as a precursor to potential hip fractures in elderly women

2021 ◽  
Author(s):  
Xuan Wu ◽  
Xiang-xu Chen ◽  
Li-yong Bai ◽  
Hui Chen ◽  
Yun-feng Rui
Keyword(s):  
Hip Fracture ◽  
Vertebral Fracture ◽  
Hip Fractures ◽  
Vertebral Fractures ◽  
Elderly Women ◽  
Statistical Significance ◽  
Osteoporosis Treatment ◽  
Low Energy ◽  
Functional Training ◽  
Number Of Patients

Abstract Objective: The purpose of this study was to investigate the kind of low-energy fracture which is a precursor of hip fracture in the elderly, and to suggest the importance of osteoporosis treatment and gait training for fall prevention after this low-energy fracture to prevent the occurrence of secondary hip fracture. Methods: From January 2017 to December 2020, a total of 564 patients who underwent surgical treatment for hip fractures were admitted to the Zhongda Hospital affiliated to Southeast University. Baseline information including gender, age, diagnosis and type of low-energy fracture before hip fracture were collected. FRAX score, the number of patients received functional training and the number of patients received anti-osteoporosis treatment were analyzed. Results: There were180 male patients and 384 female patients in the total 564 patients. The number of male patients with low-energy fractures before hip fracture was 28, including hip fracture (8 cases), vertebral fracture (8 cases) and humeral fracture (7 cases), and radial fracture (5 cases). The number of female hip fracture patients with a low-energy fracture before fracture was 62, containing vertebral fracture (31 cases), hip fracture (15 cases), radial fracture (9 cases) and humeral fracture (7 cases). It was found that vertebral fractures were the most frequent low-energy fractures that preceded hip fractures in elderly women compared to other low-energy fractures. It was showed that the 10-year probability of hip fracture and other site fractures was significantly higher in the group with lumbar fractures and other site fractures than those in the group without fractures assessed by using the FRAX measurement system. There were no statistical significance among the three groups of patients who underwent functional training and anti-osteoporosis treatment. We could not find statistical significance among the three groups of patients who underwent functional training and anti-osteoporosis treatment. Conclusion: Vertebral fracture is a precursor of hip fracture in elderly women. In face of the vertebral fractures, surgeons, especially orthopedic surgeons, should pay extra attention to the treatment of osteoporosis and anti-fall functional training.

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