TBA (18A115)

Early recognition of people at high risk of osteoporotic hip fractures and indication of primary and secondary prevention.

Author(s)

Dr Mark Phelan (Supervisor) Dr Salamet Ali (Lead)

Department(s)/Institutions

Rheumatology South Infirmary Victoria University Hospital ,Cork

Introduction

Osteoporosis is commonest bone disease affecting over 200 million people worldwide. In Ireland there are 18000 osteoporotic fractures annually costing an estimated 653 million euro to healthcare system. By early recognition and treatment, incidence of fractures can be reduced which can cut short economic burden on HSE.

Aims/Background

1. Early identification of osteoporosis and risk of hip fractures in elderly people

2. To determine what percentage of patients are on Primary Prevention and had hip fracture.

3. To find how many patients are offered Secondary Prevention while in Ortho Rehabilitation ward without benefit of fracture liaison services.

Method

There were 31 sequential patients included in the study who had hip fracture and met criteria of Osteoporosis and they were transferred for Rehabilitation to south Infirmary Victoria University Hospital after hip replacement in acute orthopedic unit at CUH. A detailed questionnaire was filled from patients including risk factors to calculate their pre-fracture FRAX Scores to meet criteria for osteoporosis and treatment. The Audit study started in March 2018 and ended by end of April 2018.

Results

The data was collected from 31 patients (n=31). Out of 31 there were 22 females and 9 males( F:M=22:9) . There were 29 patients above 65yrs age (93.5%).Out of 31 patients there were 30(97%) who had Pre-Fracture FRAX Score >3% (10 yrs risk of hip fracture) requiring treatment. Out of 30, only 6 patients (20%) were on primary prevention. After hip fracture, only 6 (20%) out of 30 were on treatment in Ortho Rehabilitation ward. 16% of patients had low BMI <18.5.

Conclusions

All women 65years and older, men >75 years should be assessed for risk factors for osteoporosis and probability of hip fracture in 10 yrs time using FRAX Score tool to determine indication for treatment which can save elderly population from morbidity and mortality related with fractures and reducing economic burden on healthcare system. This study further reinforces the need for proper fracture liaison services.


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