Hip fractures in a developing country: osteoporosis frequency, predisposing factors and treatment costs
Mine Durusu Tanriover1, S Gul Oz, Altug Tanriover
1Hacettepe University Faculty of Medicine, Department of Internal Medicine, Section of General Internal Medicine, 06100, Sihhiye, Ankara, Turkey. mdurusu@hacettepe.edu.tr
Insights
Hip fractures in elderly women are common, with high costs and prevalence of vitamin D insufficiency. Osteoporosis was not documented in all patients, and costs were linked to patient factors, not fracture type.
Area of Science:
- Gerontology
- Orthopedics
- Public Health
Background:
- Hip fractures represent a significant societal and individual burden.
- Elderly populations, particularly women, are disproportionately affected.
- Understanding associated comorbidities and treatment costs is crucial for healthcare planning.
Purpose of the Study:
- To determine the frequency of osteoporosis in hip fracture patients.
- To analyze in-hospital treatment costs for hip fractures.
- To identify factors influencing these costs at a tertiary care hospital.
Main Methods:
- Prospective study of 50 hip fracture patients admitted to Orthopedics and Traumatology wards.
- Data collection included patient characteristics, predisposing factors, laboratory results, bone mineral density (BMD) measurements, and hospital costs.
- Analysis focused on osteoporosis prevalence, cost determinants, and patient demographics.
Main Results:
- The mean patient age was 74.2 years, with 72% being women.
- Intertrochanteric fractures accounted for 64% of cases.
- High prevalence of vitamin D insufficiency (66%) and secondary hyperparathyroidism (66%) was observed.
- Osteoporosis was not documented in 34% of patients with available BMD measurements.
- Mean hospital expenditure was $5983, influenced by age, functional status, and length of stay, not fracture type or surgery.
Conclusions:
- Hip fractures in this cohort were associated with significant debilitation, vitamin D insufficiency, and secondary hyperparathyroidism.
- A notable proportion of patients lacked documented osteoporosis despite fracture.
- Hospital costs are primarily driven by patient-related factors and length of stay rather than specific fracture characteristics or surgical interventions.
Abstract:
Hip fractures are a burden to both society and the individual. The aim of this study was to describe the frequency of osteoporosis and the in-hospital treatment costs of patients with hip fractures admitted to Hacettepe University Faculty of Medicine Hospital. Patients with a hip fracture who were admitted to the Orthopedics and Traumatology wards between April 2003 and December 2006 were interviewed and 50 of them were enrolled prospectively in the study protocol. Patient characteristics, predisposing factors for fractures and hospital costs were recorded as well as laboratory test results and bone mineral density measurements. The mean age was 74.2 years and 72% of the patients were women. Sixty-four percent of them presented with an intertrochanteric fracture. The patient population was significantly debilitated with a high prevalence of vitamin D insufficiency and secondary hyperparathyroidism. No association was shown with T scores and dietary habits and lifestyle characteristics of patients. In 34% of patients in whom measurements were available, no osteoporosis could be documented. The mean hospital expenditure was $5983. Factors affecting the total cost were age and functional status of the patient and the duration of hospital stay, independent of the type of fracture and surgical procedure used.
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:31Osteoclasts in Bone Remodeling
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...