title: A survey of outcomes and management of patients post fragility fractures in China.
abstract: We found that the fragility hip and vertebral fractures caused excess mortality rates in this Chinese female population, which was unexpectedly lower than those in western countries and other Asian countries. This was the first nationwide survey relating to post-fracture outcomes conducted among Chinese population in Mainland China.
  
  
  BACKGROUND
  This study aimed to investigate the mortality, self-care ability, diagnosis, and medication treatment of osteoporosis following fragility hip and vertebral fractures through a nationwide survey among female patients aged over 50 in Mainland China.
  
  
  METHODS
  This was a multicenter, retrospective cohort study based on medical chart review and patient questionnaire. Female patients aged 50 or older admitted for low-trauma hip or vertebral fractures and discharged from Jan 1, 2008 to Dec 31, 2012 were followed.
  
  
  RESULTS
  Total of 1151 subjects of hip fracture and 842 subjects of vertebral fracture were included. The mean age was 73.4 ± 10.0, and the median of duration from index fracture to interview was 2.6 years. The overall 1-year, 2-year, 3-year, 4-year, and 5-year cumulative mortality rates were 3.5, 7.0, 11.2, 13.1, and 16.9 %, respectively. The first year mortality rates in hip (3.8 %, 95% CI 3.3-4.4 %) and vertebral fracture (3.1 %, 95% CI 2.5-3.7 %) were significantly higher than that in the general population (1.6 %). Impaired self-care ability was observed in 33.2, 40.6, and 23.8 % of overall, hip fracture, and vertebral fracture group, respectively. The overall diagnosis rate of osteoporosis was 56.8 %, and bone mineral density (BMD) measurement had never been conducted in 42.0 % among these women. After the index fracture, 69.6 % of them received supplements and/or anti-osteoporotic medications, among which 39.6 % only received calcium with/without vitamin D supplementation.
  
  
  CONCLUSIONS
  The osteoporotic hip and vertebral fractures caused excess mortality rates in this population of Mainland China. The current diagnosis and medical treatment following the fragility fractures is still insufficient in Mainland China.
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, China.
authors.forename: O
authors.initials: O
authors.lastname: Wang
authors.affiliation: Banan People's Hospital of Chongqing, Chongqing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Shenyang Orthopedics Hospital, Shenyang, Liaoning, China.
authors.forename: S
authors.initials: S
authors.lastname: Gong
authors.affiliation: Beijing Hospital, Beijing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Xue
authors.affiliation: The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Deng
authors.affiliation: The 309th Hospital of PLA, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Beijing Jishuitan Hospital, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.affiliation: Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Tang
authors.affiliation: Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: X
authors.initials: X
authors.lastname: Guo
authors.affiliation: People's Hospital of Zhejiang, Hangzhou, Zhejiang, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.affiliation: Wuyi First People's Hospital, Wuyi, Zhejiang, China.
authors.forename: X
authors.initials: X
authors.lastname: Jia
authors.affiliation: The Second Hospital Affiliated to Suzhou University, Suzhou, Jiangsu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Wuzhong People's Hospital of Suzhou, Wuzhong, Jiangsu, China.
authors.forename: L
authors.initials: L
authors.lastname: Lan
authors.affiliation: General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
authors.forename: C
authors.initials: C
authors.lastname: Lei
authors.affiliation: Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Dong
authors.affiliation: Xinzhou District People's Hospital of Wuhan, Wuhan, Hubei, China.
authors.forename: G
authors.initials: G
authors.lastname: Yuan
authors.affiliation: Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Yanchi Hospital, Yanchi, Ningxia, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, China. xiaweibo@medmail.com.cn.
authors.forename: W
authors.initials: W
authors.lastname: Xia
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China. xuling@pumch.cn.
authors.forename: L
authors.initials: L
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006620:Hip Fractures / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods; D016103:Spinal Fractures / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D016019:Survival Analysis
chemical_list: D050071:Bone Density Conservation Agents
keywords: China; Diagnosis; Fragility fracture; Mortality; Self-care ability; Treatment