Mortality and morbidity associated with osteoporosis drug treatment following hip fracture.
This study examined post-fracture osteoporosis drug treatment in hip fracture patients and the association of treatment with mortality and morbidity. Pre- and post-fracture demographic/health information was collected on a cohort of hip fracture patients aged 65+ years. Post-fracture administrative data on prescription drug use and health care utilization was linked to the cohort data. Five classes of osteoporosis drugs were available during the study period: hormone replacement therapy (HRT), bisphosphonates (BSP), calcitonin, selective estrogen receptor modulators (SERMs) and vitamin D(3) (Rocaltrol). Pre-fracture, 38 of 449 patients (8%) were on osteoporosis medications. Post-fracture, 81 of 356 patients (23%) were treated; 63 of these patients were untreated prior to fracture. Both treated and untreated patients had similar rates of subsequent hip fracture (6% and 4%, respectively) and Colles fracture (2%). Regardless of treatment status, patients were also equally likely to be hospitalized, both in the short-term (28% in treated, 27% in untreated) and in the long-term (43% versus 37%). However, mortality was significantly lower in the treated group. The lower mortality in the treated group, combined with the knowledge that antiresorptive drugs reduce fractures and increase bone density, merit undertaking a randomized trial to confirm our findings that antiresorptive therapy should be considered in all patients post-hip fracture.
Cree
Marilyn W
MW
Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada.
Juby
Angela G
AG
Carriere
Keumhee C
KC
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002116:Calcitonin / Q000008:administration & dosage; D002117:Calcitriol / Q000008:administration & dosage; D003266:Continuity of Patient Care; D004164:Diphosphonates / Q000008:administration & dosage; D004363:Drug Utilization / Q000706:statistics & numerical data; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome
D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D002116:Calcitonin; D002117:Calcitriol