title: The burden of previous fractures in hip fracture patients. The Break Study.
abstract: A positive history of fractures in older patients with hip fracture is common. We determined the risk factors associated with a positive history of fractures and the profile of care in hip fracture patients. In the Break Study, we enrolled 1249 women aged ≥60 years, seeking care for a hip fracture. Baseline information included age, body mass index, lifestyle (smoking habit, alcohol consumption), patient's history of fracture after the age of 50 years, family history of fragility fracture and health status (presence of comorbidity, use of specific drugs, pre-fracture walking ability, type of fracture, time to surgery, type of surgery, osteoporosis treatment). In the multivariable model age, smoking, family history, treatment with antiplatelet, anticoagulants and anticonvulsants, were significant predictors of a positive history of fracture. More than 70% of patients underwent surgery more than 48 hours after admission. About 50% were discharged with a treatment for osteoporosis, but more than 30% only with calcium and vitamin D. In conclusion, factors associated with a positive history of fracture are the traditional risk factors, suggesting that they continue to have a negative impact on health even at older ages. Selected drugs, such as antiplatelet and anticoagulants, deserve further consideration as significant factors associated with fractures. Given that delay in surgery is a major cause of mortality and disability, while treatment for osteoporosis decreases significantly the risk of recurrent fractures and disability, interventions to modify these patterns of care are urgently needed.
authors: CNR, Institute of Neuroscience, Section on Aging, via Giustiniani 2, 35128 Padova, Italy. stefania.maggi@in.cnr.it
authors: Stefania
authors: S
authors: Maggi
authors: Paola
authors: P
authors: Siviero
authors: Stefano
authors: S
authors: Gonnelli
authors: Carla
authors: C
authors: Caffarelli
authors: Giorgio
authors: G
authors: Gandolini
authors: Carlo
authors: C
authors: Cisari
authors: Maurizio
authors: M
authors: Rossini
authors: Giovanni
authors: G
authors: Iolascon
authors: Giulia Letizia
authors: GL
authors: Mauro
authors: Ranuccio
authors: R
authors: Nuti
authors: Gaetano
authors: G
authors: Crepaldi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006620:Hip Fractures / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000473:pathology / Q000628:therapy; D012307:Risk Factors