title: Osteoporotic hip fractures in non-elderly patients: relevance of associated co-morbidities.
abstract: Osteoporotic hip fractures (OHF) are not limited to elderly; however, studies in non-elderly are scarce. Thus, the aim of this study was to evaluate co-morbidities in non-elderly patients with OHF in a Community Teaching Hospital. All hospitalizations due to OHF during a 3-year period in a Community Teaching Hospital were retrospectively evaluated for co-morbidities, and patients 18-64 years old were compared with those ≥65 years old. Of all hospitalizations, 232 (0.73%) were due to hip fractures, and 120/232 (51.7%) patients had OHF. The comparison of the 13 (10.8%) OHF patients <65 years old (47.3 ± 9.7 years) with 107 (89.2%) ≥65 years old (80.4 ± 7.7 years) revealed a male predominance (61.5 vs. 27.1%, P = 0.022) and a distinct ethnic distribution with a lower proportion of Caucasians in the former (61.5 vs. 86.9%, P = 0.033). Moreover, non-elderly OHF patients had higher frequencies of insulin-dependent DM (38.5 vs. 3.7%, P = 0.001) and alcoholism (38.5 vs. 4.7%, P = 0.001) than aged patients. In contrast, rates of age-related co-morbidities such as stroke (7.7 vs. 18.7%, P = 0.461), heart failure (23.1 vs. 14.0%, P = 0.411), and dementia (7.7 vs. 15.9%, P = 0.689) were comparable in both groups. Logistic regression analysis demonstrated that insulin-dependent DM (OR = 25.4, 95% CI = 4.7-136.8, P < 0.001) and alcoholism (OR = 20.3, 95% CI = 3.9-103.3, P < 0.001) remained as independent risk factors for OHF in non-elderly patients. Osteoporosis is an important cause of HF in Community Hospital. Non-elderly patients with OHF have a peculiar demographic profile and associated co-morbidities. These findings reinforce the need of early osteoporosis diagnosis and rigorous fracture prevention in patients with DM and alcoholism.
authors.affiliation: Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo 455, 3° Andar, Sala 3190, São Paulo, SP 01246-903, Brazil. sandrapasoto@yahoo.com.br
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Pasoto
authors.forename: Liz A K
authors.initials: LA
authors.lastname: Yoshihara
authors.forename: Lucy C
authors.initials: LC
authors.lastname: Maeda
authors.forename: Marcia M S
authors.initials: MM
authors.lastname: Bernik
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfa
authors.forename: Rosa M R
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000208:ethnology; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000453:epidemiology* / Q000208:ethnology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult