title: Fragility non-hip fracture patients are at risk.
abstract: BACKGROUND
  Fragility fractures are a growing worldwide health care problem. Hip fractures have been clearly associated with poor outcomes. Fragility fractures of other bones are common reasons for hospital admission and short-term disability, but specific long-term outcome studies of non-hip fragility fractures are rare. The aim of our trial was to evaluate the 1-year outcomes of non-hip fragility fracture patients.
  
  
  METHODS
  This study is a retrospective cohort review of 307 consecutive older inpatient non-hip fracture patients. Patient data for analysis included fracture location, comorbidity prevalence, pre-fracture functional status, osteoporosis treatments and sociodemographic characteristics. The main outcomes evaluated were 1-year mortality and post-fracture functional status.
  
  
  RESULTS
  As compared to the expected mortality, the observed 1-year mortality was increased in the study group (17.6 vs. 12.2 %, P = 0.005). After logistic regression, three variables remained as independent risk factors for 1-year mortality among non-hip fracture patients: malnutrition (OR 3.3, CI 1.5-7.1), Charlson comorbidity index (CCI) (OR 1.3, CI 1.1-1.5) and the Parker Mobility Score (PMS) (OR 0.85, CI 0.74-0.98). CCI and PMS were independent risk factors for a high grade of dependency after 1 year. Management of osteoporosis did not significantly improve after hospitalization due to a non-hip fragility fracture.
  
  
  CONCLUSIONS
  The outcomes of older non-hip fracture patients are comparable to the poor outcomes of older hip fracture patients, and appear to be primarily related to comorbidities, pre-fracture function and nutritional status. The low rate of patients on osteoporosis medications likely reflects the insufficient recognition of the importance of osteoporosis assessment and treatment in non-hip fracture patients. Increased clinical and academic attention to non-hip fracture patients is needed.
authors.affiliation: Department of Medicine 2/Geriatris, Klinikum Nürnberg, Nuremberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gosch
authors.forename: T
authors.initials: T
authors.lastname: Druml
authors.forename: J A
authors.initials: JA
authors.lastname: Nicholas
authors.forename: Y
authors.initials: Y
authors.lastname: Hoffmann-Weltin
authors.forename: T
authors.initials: T
authors.lastname: Roth
authors.forename: M
authors.initials: M
authors.lastname: Zegg
authors.forename: M
authors.initials: M
authors.lastname: Blauth
authors.forename: C
authors.initials: C
authors.lastname: Kammerlander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000401:mortality; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000150:complications / Q000401:mortality* / Q000534:rehabilitation; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors