Intensive screening for osteoporosis in patients with hip fracture

Opportunities to evaluate, treat, and prevent future osteoporotic fractures are often being overlooked, especially in patients with a prior osteoporotic fracture. We find that an intensive outreach osteoporosis investigation strategy can help increase the number of patients investigated and treated for osteoporosis following a hip fracture.

Purpose: Patients experiencing a hip fracture are subject to an increased risk of subsequent fractures. This suggests an urgent need to develop strategies that will allow a higher number of patients with fragility hip fractures to be investigated and treated for osteoporosis. In accordance, we developed a secondary osteoporosis prevention program and evaluated the results of the program.

Methods: In the study period, 1071 patients with a hip fracture were admitted to Hvidovre University Hospital. Eligible patients were offered an osteoporosis investigation program, which included a DXA-scan with vertebral fracture assessment and a medical consultation. The data retrieved from this program were registered and analyzed. The primary goal of the study was to describe the number of subjects, who completed the program, and to characterize the initiated osteoporosis treatment. Secondary outcomes evaluated were prevalence of DXA-verified osteoporosis, changes in T-score due to treatment, and 1-year mortality rate.

Results: In total, 557 patients were offered participation of which 333 patients completed the full program. Among these, 159 patients had DXA-verified osteoporosis and 192 patients were started treatment. This resulted in a significant higher T-score at the lumbar spine and femoral neck compared with subjects not treated. Additionally, we report a 1-year mortality rate of 27.7% among all patients with hip fracture.

Conclusion: We report that an intensive outreach osteoporosis investigation program can help increase the number of hip fracture patients being tested and treated for osteoporosis. Further, the initiation of treatment can significantly increase the T-score.