Bisphosphonate Use and Hospitalization for Hip Fractures in Women: An Observational Population-Based Study in France

Bisphosphonates are widely used in the treatment of women at risk of osteoporotic hip fracture; however, the overall effectiveness of bisphosphonates in the prevention of osteoporotic fractures has not been studied in real life. To investigate whether the use of bisphosphonates in women aged 50 years and over is associated with a decrease in hospitalization for osteoporotic hip fractures, a historical prospective cohort study was conducted between 2009 and 2016 from a permanent representative sample consisting of 1/97 of the French health insurance beneficiaries. Bisphosphonate use was defined according to medication persistence and adherence regarding bisphosphonate dispensations. The primary outcome was the hospitalization rate for osteoporotic hip fracture. Among the 81,268 women included, 2005 were exposed to bisphosphonates. The median time of bisphosphonate exposure was 12 (IQR, 3–29) and 17 (IQR, 5–42) months for the persistence and adherence definitions, respectively. Exposure to bisphosphonates was not associated with a decrease in hospitalization for hip fracture: weighted HRadherence = 0.66 (95% CI, 0.33 to 1.33); HRpersistance = 0.77 (95% CI, 0.38 to 1.57). In real life, bisphosphonate use does not appear to reduce hospitalization for hip fractures, as to date, it is probably prescribed as primary prevention and for a duration too short to be effective.

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Epidemiology of osteoporotic fracture in Kazakhstan and development of a country specific FRAX model

Archives of Osteoporosis ◽

10.1007/s11657-020-0701-3 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 4

Author(s):

S. Issayeva ◽

O. Lesnyak ◽

A. Zakroyeva ◽

B. Issayeva ◽

D. Dilmanova ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Osteoporotic Fractures ◽

Population Based ◽

Trauma Centre ◽

Fracture Incidence ◽

Hip Fracture Incidence ◽

The Republic ◽

Country Specific ◽

Population Based Survey

Abstract Summary Retrospective and prospective population-based survey in a region of the Republic of Kazakhstan determined the incidence of fractures at the hip, proximal humerus and distal forearm. The hip fracture rates were used to create a FRAX® model to enhance fracture risk assessment in Kazakhstan. Objective This paper describes the epidemiology of osteoporotic fractures in the Republic of Kazakhstan that was used to develop a country specific FRAX® tool for fracture prediction. Methods We carried out a retrospective population-based survey in Taldykorgan in the Republic of Kazakhstan representing approximately 1% of the country’s population. Hip, forearm and humerus fractures were identified retrospectively in 2015 and 2016 from hospital registers and the trauma centre. Hip fractures were prospectively identified in 2017 from the same sources and additionally from primary care data. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Kazakhstan. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The difference in hip fracture incidence between the retrospective and prospective survey indicated that approximately 25% of hip fracture cases did not come to hospital attention. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 11,690 and is predicted to increase by 140% to 28,000 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures in men but not in women. Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Kazakh population and help guide decisions about treatment.

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EPIDEMIOLOGY OF FRACTURES OF THE PROXIMAL FEMUR IN ELDERLY RESIDENTS OF YAKUTSK

Osteoporosis and Bone Diseases ◽

10.14341/osteo201539-12 ◽

2015 ◽

Vol 18 (3) ◽

pp. 9-12

Author(s):

V V Epanov ◽

A K Lebedev ◽

A A Epanova ◽

I P Semenov ◽

G A Palshin ◽

...

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Bone Fractures ◽

Osteoporotic Fractures ◽

Population Based ◽

Incidence Rates ◽

Fracture Incidence ◽

Hip Fracture Incidence ◽

The Republic ◽

A Minor

Bone fractures of the skeleton with a minor injury is a clinical manifestation of osteoporosis and its population-based marker. The incidence of hip fracture varies in different geographic areas and ethnic groups. The aim was to study incidence of hip fractures in patients older than 40 years in the Republic of Sakha (Yakutia, Russian federation) in 2011-2013 and to compare the data with the previous study at the same region performed in 1997-2003. Material and methods. The study is a part of a multi-center international project «Epidemiological study of osteoporotic fractures in Eurasia (EVA).» It was a retrospective study followed by a prospective one. In the retrospective part the information on hip fracture cases registered in the official documents of the orthopedic service in 2011-2012 was collected. The prospective part was conducted in 2013, it was aimed at the identification of the patients with a hip fracture, applied not only in orthopedic department but also to other medical professionals, such as general practitioners. Results. Overall, in three years 426 hip fractures were reported in the city of Yakutsk. The total number of fractures in women was 286 (67.1%), in men - 140 (32.9%). We observed the increase in hip fracture incidence in 2013 (192 cases per 100,000 population in men and 283 per 100,000 in women 50 years old and older) which was 12% higher than in 2011 and 2012. We owe it to improved registration of hip fractures in the group of women 85 years old and older. The hip fracture incidence in this study significantly exceed the data of previous study 15 years ago. Conclusion. In recent years, there is an increase in incidence rates of hip fracture in Yakutsk due to improved hospitalization rates in orthopedic service.

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The Impact of Diabetes on Postoperative Outcome after Hip Fracture: A Nationwide Population-Based Study in Taiwan

SSRN Electronic Journal ◽

10.2139/ssrn.3335868 ◽

2019 ◽

Author(s):

Tien-Ching Lee ◽

Yu-Li Lee ◽

Jian-Chih Chen ◽

Chung-Hwan Chen ◽

Pei-Shan Ho

Keyword(s):

Hip Fracture ◽

Postoperative Outcome ◽

Population Based ◽

Population Based Study ◽

The Impact

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Risk factors associated with treatment of hyperactive postoperative delirium in elderly patients following hip fracture surgery under regional anesthesia: a nationwide population-based study

Brazilian Journal of Anesthesiology (English Edition) ◽

10.1016/j.bjane.2021.03.020 ◽

2021 ◽

Author(s):

Eun-Jin Ahn ◽

Si Ra Bang

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Regional Anesthesia ◽

Postoperative Delirium ◽

Population Based ◽

Population Based Study ◽

Factors Associated ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03811-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Kuang-Ting Yeh ◽

Tzai-Chiu Yu ◽

Ru-Ping Lee ◽

Jen-Hung Wang ◽

Kuan-Lin Liu ◽

...

Keyword(s):

Cohort Study ◽

Hepatic Encephalopathy ◽

Hip Fracture ◽

Hip Fractures ◽

Human Life ◽

National Database ◽

Research Database ◽

Older Individuals ◽

Osteoporotic Hip Fracture ◽

Increased Risk

Abstract Background Osteoporotic hip fracture is a common general health problem with a significant impact on human life because it debilitates the patients and largely decreases their quality of life. Early prevention of fractures has become essential in recent decades. This can be achieved by evaluating the related risk factors, as a reference for further intervention. This is especially useful for the vulnerable patient group with comorbidities. Hepatic encephalopathy (HE), a major complication of liver cirrhosis, may increase the rate of falls and weaken the bone. This study evaluated the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged population using a national database. Methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We included people who were older than 50 years with hepatic encephalopathy or other common chronic illnesses. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of osteoporotic hip fracture between the both cohorts were calculated using Cox proportional hazard regression models. Results The mean age of the enrolled patients was 66.5 years. The incidence ratio of osteoporotic hip fracture in the HE group was significantly higher than that in the non-HE group (68/2496 [2.7%] vs 98/9984 [0.98%]). Patients with HE were 2.15-times more likely to develop osteoporotic hip fractures than patients without HE in the whole group. The risk ratio was also significantly higher in female and older individuals. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer, and depression. Alcohol-related illnesses seemed to not confound the results of this study. Conclusions HE is significantly associated with an increased risk of osteoporotic hip fractures, and the significance is not affected by the comorbidities in people aged more than 50 years. The cumulative risk of fracture increases with age.

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Organization of primary medical care for patients with osteoporosis

Russian Family Doctor ◽

10.17816/rfd71151 ◽

2021 ◽

Vol 25 (2) ◽

pp. 7-17

Author(s):

Elena N. Gladkova

Keyword(s):

High Risk ◽

Medical Care ◽

Hip Fractures ◽

Osteoporotic Fractures ◽

Population Based ◽

Subsequent Treatment ◽

Primary Medical Care ◽

Screening Programs ◽

Active Identification ◽

The World

The author revises the latest evidence in the literature regarding of organizing medical care for patients with osteoporosis in primary medical care. In the world, there is an increase in the group of older people (60 years and older), therefore, the problem of osteoporosis and osteoporotic fractures becomes very urgent. In Russia, the number of hip fractures will increase by 70% by 2050 compared to 2015. The article provides an overview of studies demonstrating the clinical and cost-effectiveness of population-based screening programs for the identification and subsequent treatment of patients at high risk of fractures, and discusses the issues of secondary prevention of fractures. With the active identification of patients at high risk of fractures and the initiation of antiosteoporotic therapy, a decrease in the incidence of osteoporotic fractures, including hip fractures, is expected.

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