title: Factors associated with receiving anti-osteoporosis treatment among older persons with minimal trauma hip fracture presenting to an acute orthogeriatric service.
abstract: OBJECTIVE
  The aim of this study was to investigate factors that were associated with receiving anti-osteoporosis treatment (AOT) among patients with minimal trauma hip fracture admitted to an Australian tertiary trauma centre under the Acute Orthogeriatric Service (AOS) over a 6 month period.
  
  
  METHODS
  Observational study using prospectively collected data.
  
  
  METHODS
  Demographic and clinical characteristics of 211 patients were extracted from the local hip fracture registry and electronic medical records. The outcome measure was receipt of AOT before separation from the AOS. Binary logistic regression was used to identify factors independently associated with treatment.
  
  
  RESULTS
  91 (45%) patients received AOT, including 51 (25.2%) treatment-naive patients. Factors significantly associated with receiving treatment included higher serum vitamin D level (OR 1.44, 95% CI 1.23-1.70, p<0.001) and trochanteric vs. cervical fracture (OR 2.67, 95% CI 1.30-5.49, p=0.007). Living in a residential aged care facility (RACF) prior to the index fracture (OR 0.2, 95% CI 0.08-0.54, p=0.001) and higher American Society of Anaesthesiologists (ASA) physical status score (OR 0.5, 95% CI 0.25-0.98, p=0.04) significantly lowered the likelihood of treatment. Age, gender, cognitive impairment, premorbid walking ability, previous fragility fracture and renal impairment did not correlate with treatment.
  
  
  CONCLUSIONS
  A significant proportion (55%) of hip fracture patients did not receive AOT in hospital. The probability of receiving treatment appears to be significantly associated with serum vitamin D level, fracture type, place of residence and comorbidity burden.
authors: Staff Specialist in Geriatric Medicine, Department of Geriatric Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Conjoint Fellow, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia. Electronic address: roshangun@yahoo.com.
authors: R
authors: R
authors: Gunathilake
authors: Staff Specialist in Geriatric Medicine, Department of Geriatric Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
authors: E
authors: E
authors: Epstein
authors: Clinical Nurse Specialist, Department of Orthopaedics, John Hunter Hospital, Newcastle, NSW, Australia.
authors: S
authors: S
authors: McNeill
authors: Staff Specialist in Geriatric Medicine, Department of Geriatric Medicine, John Hunter Hospital, Newcastle, NSW, Australia; Conjoint Senior Lecturer, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
authors: B
authors: B
authors: Walsh
mesh_terms: D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D
keywords: Antiresorptive treatment; Correlates; Hip fracture; Osteoporosis; Secondary prevention