title: [Missed opportunities for prevention of hip fracture in older patients].
abstract: OBJECTIVE
  Osteoporotic fractures are a major cause of morbidity in the population. Therefore, fracture prevention strategies should be a major concern, and one of the priorities in the primary health care system. The aim of the study was to assess fracture and fall risk factors, and fracture risk level in patients with acute hip fracture, and to evaluate if there had been adequate osteoporosis treatment prior to fracture in this group of patients.
  
  
  METHODS
  Fracture and fall risk factors were assessed in 342 patients, > or = 65 years old, hospitalized due to acute hip fracture at the Clinic for Orthopedic Surgery and Traumatology, Clinical Centre of Serbia in a 12-month period. Fall risk factors were assessed with the Fracture Risk Assessment (FRAX) algorithm, and patients were classified in respect to fracture risk level.
  
  
  RESULTS
  Hip fracture occurred in the majority of the patients in the high risk group (74.2%), where no additional bone mineral density testing was needed. Less than 10% of the patients had a diagnosis of osteoporosis before injury, while less than 2% were treated. Cognitive impairment (95.3%), visual impairment (58.2%), lower index of daily activities (51.8%), and depression (47.1%) were the most frequently observed fall risk factors.
  
  
  CONCLUSIONS
  The results of our investigation reveal insufficient identification of clinical fracture risk factors in the primary care setting, inadequate treatment of osteoporosis and, consequently, ineffective prevention of hip fractures in the geriatric population. The introduction of FRAX into clinical practice enables more effective acknowledgment of patients with elevated fracture risk, even if bone density measurement is not available. The results of this study have a special significance for everyday clinical practice, because they impose a need for reviewing the existing approaches to osteoporosis prevention, and precise definiment of hip prevention strategies.
authors: Klinika za fizikalnu medicinu i rehabilitaciju, Klinicki Centar Srbije, Beograd, Srbija. edubljaninraspopovic@gmail.com
authors: Emilija
authors: E
authors: Dubljanin-Raspopović
authors: Ljiljana Denić
authors: LD
authors: Marković
authors: Goran
authors: G
authors: Tulić
authors: Mirko
authors: M
authors: Grajić
authors: Sanja
authors: S
authors: Tomanović
authors: Marko
authors: M
authors: Kadija
authors: Marko
authors: M
authors: Bumbasirević
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors