title: Antiresorptive treatment, when initiated after a first hip fracture, may not protect of a second contralateral episode in elderly population: A study with 685 patients.
abstract: BACKGROUND
  Osteoporosis predisposes for a higher risk of hip fracture and its treatment is frequently underprescribed. Our purpose was to assess the relation between having a second hip fracture and receiving osteoporosis treatment. Also to assess the relation between this second fracture and using central nervous system drugs or being institutionalised.
  
  
  METHODS
  We reviewed all the patients that were admitted to our hospital with an osteoporotic proximal femoral fracture between September 2009 and February 2011. We identified 685 patients, 74 of which presented a contralateral fracture. We evaluated if they were receiving osteoporosis treatment or taking any medication that could affect the central nervous system and if they were institutionalised.
  
  
  RESULTS
  A 10.8% of patients had a second fracture and the mean time between the two of them was 20 months (1-122). There was a clear female predominance (76.35%). The mean age at occurrence of the primary fracture was 83.02 years and 85 for the second. A 90.8% did not follow any type of osteoporosis medication before the first fracture. A 50.9% did not receive central nervous system drugs and 79.1% lived at home at the time of the first fracture. 12.8% of the patients that did not follow the osteoporosis treatment, had a contralateral fracture, 3% more than those that did follow some kind of treatment, but this difference was not significant (p=0.2).
  
  
  CONCLUSIONS
  We identified a similar number of patients undergoing osteoporotic treatment as registered in literature. There was no significant difference between suffering a second hip fracture and following osteoporosis treatment, using psychotropic drugs or being institutionalised.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. Electronic address: mobesalduch@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Besalduch
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Carrera
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gómez-Masdeu
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: De Caso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D006620:Hip Fractures / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007326:Institutionalization; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents; D011619:Psychotropic Drugs; D002118:Calcium
keywords: Contralateral hip fracture; Hip fracture; Osteoporosis