title: Fracture prevention strategies in patients presenting to Australian hospitals with minimal-trauma fractures: a major treatment gap.
abstract: BACKGROUND
  The aim of this study was to examine current fracture prevention strategies through the recognition, investigation and treatment of osteoporosis in patients presenting to acute hospitals with minimal-trauma fracture.
  
  
  METHODS
  A retrospective audit using a standardized database was conducted in 16 Australian hospitals. This involved 1829 cases of minimal-trauma fracture initially presenting to hospital emergency departments during 2003-2005. Cases of minimal-trauma fracture were retrospectively identified using diagnosis-related group fracture codes and case record review at each site. Relevant data were entered into a standardized database and analysed centrally and independently. Risk factors for osteoporosis, investigations, interventions and discharge follow up were recorded.
  
  
  RESULTS
  The percentage of minimal-trauma fracture patients who underwent investigation or initiated therapy designed to prevent subsequent minimal-trauma fracture was obtained. Less than 13% of patients presenting to hospital with minimal-trauma fractures had risk factors for fracture identified. Ten per cent were appropriately investigated, 12% were commenced on calcium and 12% on vitamin D. Eight per cent started bisphosphonates and 1% selective oestrogens receptor modulators in the acute setting.
  
  
  CONCLUSIONS
  Most patients presenting to Australian hospitals with minimal-trauma fracture are neither investigated nor treated for osteoporosis. As this group is at high risk of subsequent fracture, this is a missed opportunity to reduce fracture burden.
authors: Department of Endocrinology and Diabetes Southern Health, Monash Institute of Public Health Research, Melbourne, Victoria, Australia. helena.teede@med.monash.edu.au
authors: H J
authors: HJ
authors: Teede
authors: I A
authors: IA
authors: Jayasuriya
authors: C P
authors: CP
authors: Gilfillan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002136:Calcium, Dietary / Q000627:therapeutic use; D003133:Commission on Professional and Hospital Activities / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D006761:Hospitals / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002136:Calcium, Dietary