title: Characteristics of elderly patients admitted to an urban tertiary care hospital with osteoporotic fractures: correlations with risk factors, fracture type, gender and ethnicity.
abstract: Osteoporosis is a major public health problem in the United States of America and around the world, largely due to the morbidity and mortality associated with osteoporotic fractures. In the past decade, large epidemiologic studies have contributed greatly to our understanding of patients who fracture. However, most studies are limited to postmenopausal white women. In this retrospective review, we analyze data from 185 men and women with acute fragility fractures who received osteoporosis consultations during admission to a single urban hospital between 2001 and 2003. Men and women differed in terms of risk factors for falls and osteoporosis but had areal bone mineral density (BMD) measurements remarkably similar, except at the total hip. Black and Hispanic subjects with fractures were significantly younger than whites yet were much more likely to have serious co-morbidities, such as diabetes mellitus and hypertension. In spite of significantly higher BMD measurements, black patients had the highest rates of vitamin D deficiency and secondary hyperparathyroidism. Patients admitted with hip fractures differed from those with non-hip fractures on a number of important variables. Based on these data, we conclude that elderly subjects admitted to an urban hospital with osteoporotic fractures are a heterogeneous group, with features that vary according to fracture type, gender and ethnicity. Future studies of patients with clinical fragility fractures should include ample numbers of men and ethnic minorities, since differences in underlying risk factors may suggest alternative strategies for fracture prevention.
authors.affiliation: Department of Medicine's Metabolic Bone Unit and Toni Stabile Osteoporosis Center, Columbia University College of Physicians and Surgeons, Harkness Pavilion 904, 180 Ft. Washington Avenue, New York, New York, USA. cb2006@columbia.edu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Becker
authors.forename: Scott
authors.initials: S
authors.lastname: Crow
authors.forename: Jared
authors.initials: J
authors.lastname: Toman
authors.forename: Carter
authors.initials: C
authors.lastname: Lipton
authors.forename: Don J
authors.initials: DJ
authors.lastname: McMahon
authors.forename: William
authors.initials: W
authors.lastname: Macaulay
authors.forename: Ethel
authors.initials: E
authors.lastname: Siris
mesh_terms: D000058:Accidental Falls; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005006:Ethnicity; D005260:Female; D050723:Fractures, Bone / Q000208:ethnology / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000208:ethnology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States; D014505:Urban Population; D014808:Vitamin D Deficiency / Q000150:complications / Q000208:ethnology