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. 2010 Apr;58(4):650-7.
doi: 10.1111/j.1532-5415.2010.02769.x.

Missed opportunities for osteoporosis treatment in patients hospitalized for hip fracture

Lee A Jennings  1 , Andrew D Auerbach, Judith Maselli, Penelope S Pekow, Peter K Lindenauer, Sei J Lee
Affiliations

Missed opportunities for osteoporosis treatment in patients hospitalized for hip fracture

Lee A Jennings et al. J Am Geriatr Soc. 2010 Apr.

Abstract

Objectives: Although osteoporosis treatment can dramatically reduce fracture risk, rates of treatment after hip fracture remain low. In-hospital initiation of recommended medications has improved outcomes in heart disease; hospitalization for hip fracture may represent a similar opportunity for improvement. The objective of this study was to examine rates of in-hospital treatment with a combination of calcium and vitamin D (Cal+D) and antiresorptive or bone-forming medications in patients hospitalized for hip fractures

Design: Observational cohort.

Setting: Three hundred eighteen hospitals in the United States.

Participants: Fifty-one thousand three hundred forty-six patients aged 65 and older hospitalized for osteoporotic hip fracture.

Measurements: In-hospital administration of Cal+D and antiresorptive or bone-forming medications.

Results: Three thousand four hundred five patients (6.6%) received Cal+D anytime after a procedure to correct femoral fracture; 3,763 patients (7.3%) received antiresorptive or bone-forming medications. Only 1,023 patients (2.0%) were prescribed ideal therapy, receiving Cal+D and an antiresorptive or bone-forming medication. Treatment rates remained low across virtually all patient-, provider-, and hospital-level characteristics. The strongest predictor of treatment with Cal+D was the receipt of an antiresorptive or bone-forming medication (adjusted odds ratio=5.50, 95% confidence interval=4.84-6.25), but only 27.2% of patients who received these medications also received Cal+D.

Conclusion: Rates of in-hospital initiation of osteoporosis treatment for patients with hip fracture are low and may represent an opportunity to improve care.

Keywords: Calcium; Hip Fracture; Osteoporosis; Vitamin D.

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Conflict of interest statement

Conflict of Interest Disclosures:

Figures

Figure 1
Figure 1
Criteria Used to Define the Final Cohort of Patients Eligible for Osteoporosis Treatment.
Figure 2
Figure 2
Rates of Inpatient Treatment After Hip Fracture Surgery Prophylactic Antibiotics for Surgery and DVT prophylaxis rates were determined for the day of surgery and post-operative day 1.
See this image and copyright information in PMC

Comment in

  • Preventing the next "bone event".
    Adler RA. Adler RA. J Am Geriatr Soc. 2010 Apr;58(4):762-4. doi: 10.1111/j.1532-5415.2010.02778.x. J Am Geriatr Soc. 2010. PMID: 20398160 No abstract available.

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