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Observational Study
. 2017 Jan;100(1):29-39.
doi: 10.1007/s00223-016-0193-8. Epub 2016 Oct 14.

Burden of First Osteoporotic Hip Fracture in Spain: A Prospective, 12-Month, Observational Study

Jose Ramón Caeiro  1 , Agustí Bartra  2 , Manuel Mesa-Ramos  3 , Íñigo Etxebarría  4 , Jorge Montejo  5 , Pedro Carpintero  6 , Francesc Sorio  7 , Sonia Gatell  7 , Andrea Farré  7 , Laura Canals  7 ; PROA investigators
Collaborators, Affiliations
Observational Study

Burden of First Osteoporotic Hip Fracture in Spain: A Prospective, 12-Month, Observational Study

Jose Ramón Caeiro et al. Calcif Tissue Int. 2017 Jan.

Abstract

The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included. Twenty-two percent of patients reported a prior non-hip low-trauma fracture, 16 % were receiving osteoporotic treatment at baseline, and 3 % had densitometry performed (1.8 % T-score ≤-2.5). Sixteen percent of patients died (women 14 %; men 25 %; p = 0.0011) during the first year. Mean hospital stay was 11.8 ± 7.9 days and 95.1 % of patients underwent surgery. Other relevant HRUs were: outpatient visits in 78 % of patients (mean 9.2 ± 9.7); walking aids, 58.7 %; rehabilitation facilities, 35.5 % (28.7 ± 41.2 sessions); and formal and informal home care, 22.2 % (49.6 ± 72.2 days) and 53.4 % (77.1 ± 101.0 h), respectively. Mean direct cost was €9690 (95 % confidence interval: 9184-10,197) in women and €9019 (8079-9958) in men. Main cost drivers were: first hospitalization episode (women €7067 [73 %]; men €7196 [80 %]); outpatient visits (€1323 [14 %]; €997 [11 %]); and home care (€905 [9 %]; €767 [9 %]). QoL and autonomy showed a marked decrease during hospitalization, not entirely recovered at 12 months (p < 0.05 vs. baseline for EQ-5D, Harris hip score and modified Barthel index). In a Spanish setting, osteoporotic hip fractures incur a high societal and economic cost, mainly due to the first hospitalization HRU, but also due to subsequent outpatient visits and home care.

Keywords: Autonomy; Cost; Hip fracture; Osteoporosis; Quality of life.

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Conflict of interest statement

Compliance with Ethical StandardsConflict of interestF Sorio, S Gatell, A Farre and L Canals are employees of Amgen. JR Caeiro has participated as principal investigator and/or collaborator in clinical trials sponsored by Lilly and Amgen and has been speaker at scientific events of Lilly, Merck, Pfizer and Servier. M. Mesa has been principal investigator in a clinical trial sponsored by Nycomed and speaker at scientific events of Procter & Gamble, Lilly and MSD. P Carpintero has participated as principal investigator in clinical trials sponsored by Amgen, MSD, Lilly and Nycomed, has been speaker at scientific events of Amgen, MSD, Lilly and Nycomed and has been advisor of MSD, Lilly y Bayer. A Bartra, I Etxebarría and J Montejo declare that they have no conflict of interest.Human and Animal RightsAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.Informed ConsentInformed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Mortality in the overall group and by gender in the first year after a first osteoporotic hip fracture
See this image and copyright information in PMC

References

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