Failure in diagnosis and under-treatment of osteoporosis in elderly patients with fragility fractures

  • Sofia Bougioukli
  • Panagoula Κollia
  • Theodora Koromila
  • Sokratis Varitimidis
  • Michael Hantes
  • Theofilos Karachalios
  • Κonstantinos Ν. Malizos
  • Zoe H. Dailiana
Original Article
  • 53 Downloads

Abstract

We evaluated whether osteoporosis is adequately managed and treated in patients suffering from fragility fractures. Factors that influenced osteoporosis diagnosis and treatment rates were also assessed. To this end, patients with the principal diagnosis of low-energy hip, vertebral, or distal radius fractures were recruited for the study. Collected data included risk factors for osteoporosis, history of previous fractures, known history of osteoporosis, and osteoporosis treatment at the time of admission. The patients’ prefracture risk profile was also assessed to determine whether osteoporosis could have been identified prior to the index fracture. We identified 308 patients with fragility fractures, including 214 hip, 41 vertebral, and 53 distal radius fractures. Overall, 238 patients (77.3%) had at least one risk factor for osteoporosis. Eighty-eight patients (28.6%) had sustained ≥ 1 prior fragility fractures in the past. However, only 79 patients (25.6%) were aware that they had osteoporosis and even fewer (66 patients, 21.4%) had been receiving osteoporosis treatment preceding the current admission. Anti-osteoporotic agents were more commonly prescribed in patients 66–75 years old (p = 0.008), with a family history of osteoporosis (p = 0.009) or history of a prior fragility fracture (p = 0.012). The treatment rate was higher in women than men (p = 0.026) and in patients with vertebral or multiple prior fractures compared to patients with prior hip fractures. The current study provides evidence that individuals who experience fragility fractures are not adequately managed for osteoporosis. Only few of the historically known risk factors for osteoporosis were adequately recognized and associated with osteoporosis evaluation and treatment.

Keywords

Fragility fracture Osteoporosis Osteoporosis risk assessment Anti-osteoporotic treatment 

Notes

Acknowledgements

The authors would like to thank Dr. Antonios Koutalos for his invaluable assistance with patient interviews.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study has been approved by the University’s institutional research board and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Supplementary material

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Supplementary material 1 (DOCX 472 kb)
774_2018_923_MOESM2_ESM.docx (78 kb)
Supplementary material 2 (DOCX 78 kb)

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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Sofia Bougioukli
    • 1
  • Panagoula Κollia
    • 2
  • Theodora Koromila
    • 2
  • Sokratis Varitimidis
    • 1
  • Michael Hantes
    • 1
  • Theofilos Karachalios
    • 1
  • Κonstantinos Ν. Malizos
    • 1
  • Zoe H. Dailiana
    • 1
  1. 1.Department of Orthopaedic Surgery, Faculty of MedicineUniversity of ThessalyLarissaGreece
  2. 2.Department of Genetics and Biotechnology, Faculty of BiologyNational and Kapodistrian University of AthensAthensGreece

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