Second hip fracture and patients' medication after the first hip fracture: a follow-up of 221 hip fracture patients in Finland.
The national Finnish guidelines for medical treatment of hip fracture patients are: anti-osteoporotic drugs and the daily concomitant use of calcium plus vitamin D supplements. We investigated the incidence, the fracture type and the side of all second hip fractures among 221 consecutive hip fracture patients who were followed up for 5 years. The medication of the patients and the time interval between the first and second hip fracture were analyzed. Of the patients 12% (26/221) sustained a second hip fracture. The type of fracture was in most cases (76%) the same as in the first case, more often in trochanteric and subtrochanteric fractures than in cervical fractures. The mean interval between the fractures was 4±4.2 years (±S.D.); 3.2±3.5 years in men and 4.4±4.4 years in women. The number of patients using polypharmacy (5 or more drugs daily) was 9/25 (36%) at the time of the first hip fracture and 17/25 (68%) at the time of the second hip fracture. The use of at least one psychotropic drug regularly rose from 9/25 (36%) to 16 (64%) between the two fractures. Concomitant use of calcium plus vitamin D and anti-osteoporotic drugs was insufficient among the patients. More effort should be focused on the secondary prevention following the first hip fracture.
Kaukonen
Juha-Pekka
JP
Päijät-Häme Central Hospital, Vasaroisenkatu 5 C, FI-15900 Lahti, Finland. j-p.kaukonen@phnet.fi
Lüthje
Peter
P
Nurmi-Lüthje
Ilona
I
Kataja
Matti
M
Naboulsi
Helena
H
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012008:Recurrence; D012307:Risk Factors; D014807:Vitamin D / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D011619:Psychotropic Drugs; D014807:Vitamin D; D002118:Calcium