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01.12.2023 | Original Article

Osteoporotic fracture admissions compared to other major medical admissions in Irish public hospitals

verfasst von: D. O.’Sullivan, C. Silke, B. Whelan, B. McGowan, M. O.’Sullivan, J. P. McCabe, F. Heaney, C. Armstrong, A. M. Gsel, B. Connaughton, J. J. Carey

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2023

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Abstract

Summary

Multinational reports suggest Ireland has one of the greatest illness burdens related to osteoporosis. Hospital care represents the costliest portion of health services. We found public hospital bed days for fragility fractures in Ireland increased by 43% between 2008 and 2017 which exceeded those for other common diseases.

Introduction

Recent multinational reports suggest Ireland has one of the greatest illness burdens related to osteoporosis, manifesting clinically as fragility fractures (FF). International reports show that FF incidence, rate of hospital admission and cost are similar or greater than those for breast cancer, myocardial infarction and stroke. Studies addressing the illness burden of osteoporosis in Ireland are few, and none compares fragility fractures to other common chronic diseases.

Methods

A retrospective analysis of national administrative data for all public hospital admissions was performed on adults aged 50 years and older from January 2008 to December 2017.

Results

In 2017, public hospital bed days for FF totalled 249,887 outnumbering Chronic Obstructive Pulmonary Disease (COPD): 131,897; 6 solid cancers (CA): 118,098; myocardial infarction (MI): 83,477; and diabetes mellitus (DM): 31,044. Bed days for FF increased by 43% between 2008 and 2017, in contrast to a 32%, 28% and 31% reduction for CA, MI and DM, respectively, and a 12% increase for COPD. Public hospital bed days for FF in 2016 were greater than MI, stroke, atrial fibrillation and chest pain combined but less than a combination of COPD, pneumonia and lower respiratory tract infection.

Conclusion

Osteoporotic fractures represent a large and rapidly increasing illness burden amongst older Irish adults, with substantial care requirements and the resulting onus on our healthcare system. Urgent action is needed to address this public health issue and the services for those at risk of fracture.

Hernlund E et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1CrossRefPubMedPubMedCentral

Borgstrom F et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59. https://doi.org/10.1007/s11657-020-0706-yCrossRefPubMedPubMedCentral

Investigators H et al (2019) Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med 381:2199–2208. https://doi.org/10.1056/NEJMoa1906190CrossRef

Compston JE, McClung MR, Leslie WD (2019) Osteoporosis. Lancet 393:364–376. https://doi.org/10.1016/S0140-6736(18)32112-3CrossRefPubMed

Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561. https://doi.org/10.1007/s001980070075CrossRefPubMed

Lewiecki EM et al (2020) Osteoporotic fracture trends in a population of US managed care enrollees from 2007 to 2017. Osteoporos Int 31:1299–1304. https://doi.org/10.1007/s00198-020-05334-yCrossRefPubMedPubMedCentral

Williams SA et al (2020) Economic burden of osteoporotic fractures in US managed care enrollees. Am J Manag Care 26:e142–e149. https://doi.org/10.37765/ajmc.2020.43156CrossRefPubMed

Cosman F et al (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381. https://doi.org/10.1007/s00198-014-2794-2CrossRefPubMedPubMedCentral

Lewiecki EM et al (2020) Core principles for fracture prevention: North American consensus from the National Osteoporosis Foundation, Osteoporosis Canada, and Academia Nacional de Medicina de Mexico. Osteoporos Int 31:2073–2076. https://doi.org/10.1007/s00198-020-05541-7CrossRefPubMed

10.

Kanis JA et al (2017) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int 28:2023–2034. https://doi.org/10.1007/s00198-017-4009-0CrossRefPubMedPubMedCentral

11.

Cauley JA (2013) Public health impact of osteoporosis. J Gerontol A Biol Sci Med Sci 68:1243–1251. https://doi.org/10.1093/gerona/glt093CrossRefPubMedPubMedCentral

12.

Gill PJ et al (2022) Prevalence, cost, and variation in cost of pediatric hospitalizations in Ontario Canada. JAMA Netw Open 5:e2147447. https://doi.org/10.1001/jamanetworkopen.2021.47447CrossRefPubMedPubMedCentral

13.

Singer A et al (2015) Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc 90:53–62. https://doi.org/10.1016/j.mayocp.2014.09.011CrossRefPubMed

14.

Cauley JA et al (2008) Incidence of fractures compared to cardiovascular disease and breast cancer: the Women’s Health Initiative Observational Study. Osteoporos Int 19:1717–1723. https://doi.org/10.1007/s00198-008-0634-yCrossRefPubMedPubMedCentral

15.

Piscitelli P et al (2012) Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records. Clin Interv Aging 7:575–583. https://doi.org/10.2147/CIA.S36828CrossRefPubMedPubMedCentral

16.

Kanis JA, McCloskey EV (1996) Evaluation of the risk of hip fracture. Bone 18:127S-132S. https://doi.org/10.1016/8756-3282(95)00493-9CrossRefPubMed

17.

Kelly MA et al (2018) Emerging trends in hospitalisation for fragility fractures in Ireland. Ir J Med Sci 187:601–608. https://doi.org/10.1007/s11845-018-1743-zCrossRefPubMed

18.

McGowan B, Casey MC, Silke C, Whelan B, Bennett K (2013) Hospitalisations for fracture and associated costs between 2000 and 2009 in Ireland: a trend analysis. Osteoporos Int 24:849–857. https://doi.org/10.1007/s00198-012-2032-8CrossRefPubMed

19.

McGowan B, Kanis JA, Johansson H, Silke C, Whelan B (2013) Development and application of FRAX in the management of osteoporosis in Ireland. Arch Osteoporos 8:146. https://doi.org/10.1007/s11657-013-0146-zCrossRefPubMed

20.

Gannon B, O’Shea E, Hudson E (2008) Economic consequences of falls and fractures among older people. Ir Med J 101:170–173PubMed

21.

Svedbom A et al (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8:137. https://doi.org/10.1007/s11657-013-0137-0CrossRefPubMedPubMedCentral

22.

Ireland HSE. o. Strategy to prevent falls and fractures in Ireland’s ageing population. (Website, 2008).

23.

Kanis JA et al (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos 16:82. https://doi.org/10.1007/s11657-020-00871-9CrossRefPubMedPubMedCentral

24.

Lewiecki EM et al (2018) Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 29:717–722. https://doi.org/10.1007/s00198-017-4345-0CrossRefPubMed

25.

Kelly MA et al (2020) Osteoporotic vertebral fractures are common in hip fracture patients and are under-recognized. J Clin Densitom. https://doi.org/10.1016/j.jocd.2020.05.007CrossRefPubMed

26.

McCabe E et al (2020) A systematic review of the Irish osteoporotic vertebral fracture literature. Arch Osteoporos 15:34. https://doi.org/10.1007/s11657-020-0704-0CrossRefPubMed

27.

Mohammad A et al (2014) The prevalence of vertebral fracture on vertebral fracture assessment imaging in a large cohort of patients with rheumatoid arthritis. Rheumatology (Oxford) 53:821–827. https://doi.org/10.1093/rheumatology/ket353CrossRefPubMed

28.

Carey JJ et al (2021) Vertebral fractures in Ireland: a sub-analysis of the DXA HIP project. Calcif Tissue Int. https://doi.org/10.1007/s00223-021-00868-7CrossRefPubMedPubMedCentral

29.

Williamson S et al (2017) Costs of fragility hip fractures globally: a systematic review and meta-regression analysis. Osteoporos Int 28:2791–2800. https://doi.org/10.1007/s00198-017-4153-6CrossRefPubMed

30.

Tarantino U et al (2010) The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study. Arthritis Res Ther 12:R226. https://doi.org/10.1186/ar3213CrossRefPubMedPubMedCentral

31.

Kaffashian S et al (2011) The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos). Age Ageing 40:602–607. https://doi.org/10.1093/ageing/afr085CrossRefPubMed

32.

Borgstrom F et al (2013) The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) – quality of life during the first 4 months after fracture. Osteoporos Int 24:811–823. https://doi.org/10.1007/s00198-012-2240-2CrossRefPubMed

33.

Shi N, Foley K, Lenhart G, Badamgarav E (2009) Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures. Bone 45:1084–1090. https://doi.org/10.1016/j.bone.2009.07.086CrossRefPubMed

34.

Nordström P, Gustafson Y, Michaëlsson K, Nordström A (2015) Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden. BMJ (Clinical research ed) 350:h696. https://doi.org/10.1136/bmj.h696CrossRefPubMed

35.

Walsh ME et al (2021) Trends in hip fracture care in the Republic of Ireland from 2013 to 2018: results from the Irish Hip Fracture Database. Osteoporos Int 32:727–736. https://doi.org/10.1007/s00198-020-05636-1CrossRefPubMed

36.

Ferris H, Brent L, Sorensen J, Ahern E, Coughlan T (2021) Discharge destination after hip fracture: findings from the Irish hip fracture database. Eur Geriatr Med. https://doi.org/10.1007/s41999-021-00556-7CrossRefPubMed

37.

Boonen S et al (2004) Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 15:87–94. https://doi.org/10.1007/s00198-003-1515-zCrossRefPubMed

38.

OECD, Systems, E. O. o. H. & Policies. Ireland: Country Health Profile 2021. (2021).

Titel: Osteoporotic fracture admissions compared to other major medical admissions in Irish public hospitals
verfasst von: D. O.’Sullivan
C. Silke
B. Whelan
B. McGowan
M. O.’Sullivan
J. P. McCabe
F. Heaney
C. Armstrong
A. M. Gsel
B. Connaughton
J. J. Carey
Publikationsdatum: 01.12.2023
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2023
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01199-2

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Osteoporotic fracture admissions compared to other major medical admissions in Irish public hospitals

Abstract

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Introduction

Methods

Results

Conclusion

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Abstract

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Results

Conclusion

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