title: Secondary confounders of osteoporotic hip fractures in patients admitted to a geriatric acute care department.
abstract: BACKGROUND
  With respect to the pathogenesis of osteoporosis, primary and secondary forms of the disease can be distinguished. It has been recognized that the incidence of primary and secondary osteoporosis differs in women and men.
  
  
  OBJECTIVE
  The aim of the present study was to assess the incidence and gender distribution of factors contributing to osteoporosis in older hip fracture patients.
  
  
  METHODS
  In this cross-sectional study 404 patients with hip fractures and controls referred to an acute geriatric care department over a period of 15 months were included. The medical history was recorded and blood samples were analyzed for routine laboratory parameters.
  
  
  RESULTS
  A total of 249 patients with hip fractures and 155 matched controls were studied. The Tinetti test and the Barthel index were found to show highly significant differences in both groups mainly because of the postoperative state of patients with fractures. Vitamin D deficiency was found in 94.1% of male fracture patients and 94.6% of female fracture patients. On average 2.4 secondary contributors of osteoporosis were present in male fracture patients versus 2.9 in male controls and 2.3 in female fracture patients versus 2.3 in female controls. For most parameters no significant gender differences of possible secondary contributors to osteoporosis were found. Secondary osteoporosis was diagnosed in all male fracture patients and in 56.2% of all female fracture patients.
  
  
  CONCLUSIONS
  Based on the findings of this study it is recommended that hip fracture patients should be assessed for secondary contributors of osteoporosis. Although the overall distribution of secondary contributors was similar in women and men, the prevalence of secondary osteoporosis was higher in men.
authors.affiliation: Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria. peter.dovjak@gespag.at.
authors.forename: Peter
authors.initials: P
authors.lastname: Dovjak
authors.affiliation: Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Spitalsgasse 23, 1090, Vienna, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Föger-Samwald
authors.affiliation: Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria.
authors.forename: Maarit
authors.initials: M
authors.lastname: Konrad
authors.affiliation: Department of Geriatric Acute Care, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstraße 49, 4810, Gmunden, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Bichler
authors.affiliation: Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Spitalsgasse 23, 1090, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Pietschmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D063728:Secondary Care Centers / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology*
keywords: Elderly; Geriatric acute care; Hip fractures; Osteoporosis; Secondary osteoporosis