Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Oct 10;19(1):96.
doi: 10.1007/s11657-024-01453-9.

Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe

Affiliations
Observational Study

Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe

Frank Malgo et al. Arch Osteoporos. .

Abstract

Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effective for secondary fracture prevention.

Purpose: According to the 2022 Dutch 'Osteoporosis and fracture prevention' guideline, zoledronic acid (ZA) is the preferred osteoporosis treatment for hip fracture patients. Less than 25% of hip fracture patients visit the outpatient fracture liaison service, therefore inpatient administration of ZA during the hip fracture hospitalization is now recommended in patients > 75 years. In the OLVG Hospital, inpatient administration of ZA during hospitalization for hip fracture in older patients has been standard of care since 2020.

Methods: This single center retrospective observational follow-up study included hip fracture patients > 75 years admitted to the orthogeriatric ward of the OLVG Hospital, and treated with 5 mg of ZA intravenously on the day of hospital discharge between June 2020 and December 2022. Life expectancy estimated < 12 months, creatinine clearance < 35 ml/min, hypocalcemia, and high risk of osteonecrosis of the jaw were contra-indications. During three months of follow-up (FU) adverse events, emergency room visits, hospital readmissions, and death were recorded.

Results: In 161 consecutive hospitalized hip fracture patients (mean age 86 ± 6 years, 65% female, 18% nursing home) ZA was administered and no adverse events were recorded. During 3 months of FU, 8 patients (5%) visited the emergency room, 19 patients (12%) were re-admitted to the hospital, 3 with a new fracture (2 contralateral hip, 1 radius), and 17 patients (11%) died of reasons unrelated to ZA.

Conclusion: This study shows that inpatient administration of zoledronic acid during hip fracture hospitalization is safe and feasible to prevent future fragility fractures in older hip fracture patients.

Keywords: Hip fracture; Osteoporosis; Safety; Zoledronic acid.

PubMed Disclaimer

References

    1. Nijmeijer WS et al (2016) Prediction of early mortality following hip fracture surgery in frail elderly: the Almelo Hip Fracture Score (AHFS). Injury 47(10):2138–2143 - DOI - PubMed
    1. Vranken L et al (2018) Comorbidities and medication use in patients with a recent clinical fracture at the Fracture Liaison Service. Osteoporos Int 29(2):397–407 - DOI - PubMed
    1. van Helden S et al (2008) Bone and fall-related fracture risks in women and men with a recent clinical fracture. J Bone Joint Surg Am 90(2):241–248 - DOI - PubMed
    1. Lyles KW et al (2007) Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357(18):1799–1809 - DOI - PubMed
    1. Eekman DA et al (2014) Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporos Int 25(2):701–709 - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources