Should patients with exceptional longevity be treated for osteoporosis after a hip fracture?
Barceló Trias, Montserrat (Universitat Autònoma de Barcelona. Departament de Medicina)
Casademont i Pou, Jordi (Universitat Autònoma de Barcelona. Departament de Medicina)
Mascaró, Jordi (Universitat Autònoma de Barcelona. Departament de Medicina)
Gich, Ignasi (Institut de Recerca Sant Pau)
Torres Bonafonte, Olga H (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)

Data:	2024
Descripció:	7 pàg.
Resum:	BACKGROUND: There are no studies focusing on treatment for osteoporosis in patients with exceptional longevity after suffering a hip fracture. OBJECTIVE: To assess the advisability of initiating treatment for osteoporosis after a hip fracture according to the incidence of new fragility fractures after discharge, risk factors for mortality and long-term survival. DESIGN: Retrospective review. SETTING: A tertiary university hospital serving a population of ~425 000 inhabitants in Barcelona. SUBJECTS: All patients >95 years old admitted with a fragility hip fracture between December 2009 and September 2015 who survived admission were analysed until the present time. METHODS: Pre-fracture ambulation ability and new fragility fractures after discharge were recorded. Risk factors for 1-year and all post-discharge mortality were calculated with multivariate Cox regression. Kaplan-Meier survival curve analyses were performed. RESULTS: One hundred and seventy-five patients were included. Median survival time was 1. 32 years [95% confidence interval (CI) 1. 065-1. 834], with a maximum of 9. 2 years. Male sex [hazard ratio (HR) 2. 488, 95% CI 1. 420-4. 358] and worse previous ability to ambulate (HR 2. 291, 95% CI 1. 417-3. 703) were predictors of mortality. After discharge and up to death or the present time, 10 (5. 7%) patients had a new fragility fracture, half of them during the first 6 months. CONCLUSIONS: Few new fragility fractures occurred after discharge and half of these took place in the first 6 months. The decision to start treatment of osteoporosis should be individualised, bearing in mind that women and patients with better previous ambulation ability will have a better chance of survival.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Centenarians ; Hip fracture ; Mortality ; Older people ; Treatment of osteoporosis
Publicat a:	Age and Ageing, Vol. 53 Núm. 6 (2024) , p. afae118, ISSN 1468-2834

DOI: 10.1093/ageing/afae118
PMID: 38899445

Postprint 26 p, 731.5 KB

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