title: The effect of osteoporotic treatment on the functional outcome, re-fracture rate, quality of life and mortality in patients with hip fractures: a prospective functional and clinical outcome study on 520 patients.
abstract: Numerous high quality studies have shown the positive effects of various osteoporotic medical treatment regimens on bone mass and on the reduction of risk for new spinal, hip and non-spinal fractures in osteoporotic patients. However, the effect of osteoporotic treatment on the functional and clinical outcome of patients who have sustained hip fractures and been treated surgically has not yet been addressed. Five hundred and twenty patients out of 611 who were admitted (2009-2011), operated on due to a hip fracture and completed their follow-up evaluations were included in this study. Data related to functional outcome scores, re-fracture rate, quality of life and mortality rate were prospectively recorded, analysed and correlated to osteoporotic medical treatment. There were 151 (25%) men and 369 (71%) women with a mean age of 80.7 years (range, 60 to 90 years). At a mean follow-up of 27.5 months (range, 24 to 36 months) a mortality rate of 23.6% at 2 years was recorded. Mean values of functional and quality of life scores were found to have progressively improved within two years after surgery. Seventy-eight (15%) patients were taking osteoporotic treatment before their hip fracture and 89 (17.1%) started afterwards. Osteoporotic treatment proved to be an important predictor of functional recovery (all p values<0.05), re-fracture rate (p=0.028) and quality of life (EQ-5D, all dimensions, p values<0.05). Osteoporotic treatment did not affect post-fracture mortality rates. Osteoporotic treatment taken before or initiated after fracture is a strong predictor of functional and clinical outcome in patients with hip fractures treated surgically.
authors.affiliation: Department of Orthopaedic Surgery, School of Health Sciences, Faculty of Medicine, University of Thessalia, CERETETH, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece. Electronic address: kmakrid@yahoo.gr.
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Makridis
authors.affiliation: Department of Orthopaedic Surgery, School of Health Sciences, Faculty of Medicine, University of Thessalia, CERETETH, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece. Electronic address: kar@med.uth.gr.
authors.forename: Theofilos
authors.initials: T
authors.lastname: Karachalios
authors.affiliation: Department of Orthopaedic Surgery, School of Health Sciences, Faculty of Medicine, University of Thessalia, CERETETH, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece. Electronic address: vaskonto@gmail.com.
authors.forename: Vasilios A
authors.initials: VA
authors.lastname: Kontogeorgakos
authors.affiliation: Orhtopaedic Department, General Hospital of Volos, Polimeri 134, Volos, Greece. Electronic address: lsbadras@yahoo.gr.
authors.forename: Leonidas S
authors.initials: LS
authors.lastname: Badras
authors.affiliation: Department of Orthopaedic Surgery, School of Health Sciences, Faculty of Medicine, University of Thessalia, CERETETH, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece. Electronic address: kmalizos@otenet.gr.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium
keywords: Functional outcome; Hip fracture; Mortality rate; Osteoporosis treatment; Quality of life; Re-fracture rate; Secondary hip fracture prevention