[Why do we close our eyes while the world is falling? A study on proximal femur osteoporotic fractures in a Portuguese population].
OBJECTIVE
To characterize a population with osteoporotic proximal femur fractures in a Portuguese Hospital.


METHODS
retrospective study, by clinical report consultation of all patients 50 years and older, hospitalized at the Orthopedic department in 3 consecutive years (from 2004 to 2006) at the Caldas da Rainha Hospital due to proximal femur fracture after a low impact fall. Database with: demographic; data about fracture and its treatment; follow up after discharge; previous osteoporosis diagnosis; reference to previous or simultaneous fractures; concomitant medication; other diseases; osteoporosis medication.


RESULTS
272 hospitalizations of 267 patients in 3 years, 76% of which were women. Incidence rate of osteoporotic proximal femur fractures of 0.09%. The majority of patients had between 71 and 90 years old, median age of 80.2 years. Median ingress duration was 15.6 days. Only in 7% cases was registered the previous diagnosis of osteoporosis. Fall localization was referred in only 28% cases, in almost all cases occurred at home. There was a reference to other osteoporotic fractures in 16% cases. The majority of patients had between 1 and 5 simultaneous diseases. Fifty nine percent of patients were taking 4 or more medications. In no single case was ordered a densitometry nor registered the prescription of anti-osteoporotic treatment. The total cost of these 272 hospitalizations was 1,458.220.67 euros. There were 39 (14.6%) registered deaths in the first year after the proximal femur fracture.


CONCLUSIONS
Osteoporosis and the risk of fractures were apparently under-diagnosed in this high risk population: old, polimedicated and with diseases that potentially facilitate falls and fractures. Apparently, there was no secondary prevention of osteoporotic fractures in these patients. The proximal femur fracture incidence and associated mortality were inferior to other literature references.
Cruz
Margarida
M
Serviço de Reumatologia do Centro Hospitalar das Caldas da Rainha. cmargaridamoccruz@gmail.com
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology* / Q000209:etiology*; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D011174:Portugal; D012189:Retrospective Studies