The initiative on hip fractures of the Veneto Region

Abstract

Objective: to assess the prevalence of the most relevant environmental and individual risk factors in subjects with a recent hip fracture was the aim of this observational study promoted by the Health Authorities of the Regione Veneto (Italy).

Methods: patients aged > 60 years of both genders with a recent hip fracture not associated with malignancies, were administered questionnaires on dietary habits, sun exposure, disability score. A complete family, pharmacological and pathology history was collected together with previous falls, details of the fracture index, anthropometric data. In a subgroup of patients blood was taken for the measurements of serum 25 hydroxy-vitamin D (25OHD).

Results: the study includes 704 patients (573 women and 131 men). Mean age was 81±8 years (range 60-102). Severe pre-fracture disability was a common feature (58%) associated with multiple co-morbidities (84%), more frequently cardiovascular and neurological diseases, and specific medications. In a large proportion (86%) of the patients environmental or individual risk factors for falling were found. Vitamin D insufficiency was quite common, particularly in the regional Health Districts were strategies for preventing vitamin D deficiency were not implemented. Only a small proportion (17%) of the study population had been evaluate and treated for osteoporosis.

Conclusions: in senile patients with a recent hip fracture pre-existing disability, multiple co-morbidities, high risk of falling and inadequate intake of calcium and vitamin D was quite common. Community and case-finding interventions are highly warranted.

Keywords: co-morbidities; disability; fall; hip fracture; vitamin D.

Figure 1

Prevalence of patients with vitamin D supplementation in Veneto Region.

Figure 2

Mean 25OHD serum levels in patients with or without supplementation.

Figure 3

Prevalence of hypovitaminosis D in patient with or without supplementation.