Skip to main content

Advertisement

SpringerLink
Log in

Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Arabia

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

Hip fracture is the most clinically devastating and economically important complication of osteoporosis. Pain, suffering, loss of mobility and independence are some of the devastating consequences of hip fractures. The present study aimed to determine the main characteristics and outcomes of patients with osteoporotic hip fracture and treatment gaps at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.

Methods

This is a single-center, retrospective cohort study analyzing charts of patients > 45 years who were admitted for hip fracture secondary to low-grade trauma from 2008 to 2012.

Results

A total of 264 patients (50.4% males and 49.6% females) were included. The most common fracture types were trochanter (49%) and femoral neck (46%). History of falls was documented in 115 (43.6%) patients. Bone mineral density (BMD) was assessed in only 41 (15.5%) patients. Majority underwent surgery (92%). Surgical complications occurred in 15 (5.7%) patients and medical complications in 21 (7.9%) patients. Vitamin D and calcium were the most common medications, but given only to 45 (17%) patients. Bone mineral density (BMD) assessment was significantly more frequent post-surgery than pre-surgery (p = 0.03). Very few patients received osteoporosis-specific therapy. F ollow-up revealed that 62 (23.5%) patients died 1 year after surgery.

Conclusion

These present findings warrant urgent reassessment of clinical care and treatments provided to patients with osteoporotic hip fractures to prevent recurrent fractures. The introduction of Fracture Liaison Service (FLS) in institutions caring for patients with hip fractures as internationally recommended will definitely change the current status of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. American Academy of Orthopedic Surgeons (AAOS) (1999) Hip fracture in seniors: A call for health system reform. Position Statement 1144. Rosemont, IL

  2. Ardawi M, Maimany A, Bahksh T et al (2005) Bone mineral density of the spine and femur in healthy Saudis. Osteoporosis Int 16:43–55

    Article  Google Scholar 

  3. Gillespie W (2001) Extracts from “clinical evidence”: hip fracture. BMJ 322:986–1075

    Article  Google Scholar 

  4. Sambrook P, Cooper C (2006) Osteoporosis. Lancet 367:2010–2018

    Article  CAS  Google Scholar 

  5. Juby A, Geus-Wenceslau C (2002) Evaluation of osteoporosis treatment in seniors after hip fracture. Osteoporos Int 13:205–210

    Article  CAS  Google Scholar 

  6. Kanis JA, Cooper C, Rizzoli R et al (2019) Executive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Aging Clin Exp Res 31:15–17

    Article  CAS  Google Scholar 

  7. Kanis JA, Cooper C, Rizzoli R et al (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 1:3–44

    Article  Google Scholar 

  8. Compston J, Cooper A, Cooper C, National Osteoporosis Guideline Group (NOGG) et al (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–8

  9. Rabenda V, Vanoverloop J, Fabri V et al (2008) Low incidence of anti-osteoporosis treatment after hip fracture. Bone Jt Surg Am 90:2142–2148

    Article  Google Scholar 

  10. Jennings L, Auerbach A, Maselli J et al (2010) Missed opportunities for osteoporosis treatment in patients hospitalized for hip fracture. J Am Geriatr Soc 58:650–657

    Article  Google Scholar 

  11. Bubshait D, Sadat-Ali M (2007) Economic implications of osteoporosis-related femoral fractures in Saudi Arabian society. Calcif Tissue Int 81:455–458

    Article  CAS  Google Scholar 

  12. Wei J, Zeng L, Li S et al (2019) Relationship between comorbidities and treatment decision-making in elderly hip fracture patients. Aging Clin Exp Res. https://doi.org/10.1007/s40520-019-01134-5

    Article  PubMed  PubMed Central  Google Scholar 

  13. Abtahi S, Driessen JHM, Vestergaard P et al (2019) Secular trends in major osteoporotic fractures among 50+ adults in Denmark between 1995 and 2010. Osteoporos Int. https://doi.org/10.1007/s00198-019-05109-0

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sadat-Ali M, Alfaraidy M, AlHawas A et al (2017) Morbidity and mortality after fragility hip fracture in a Saudi Arabian population: report from a single center. J Int Med Res 45:1175–1180

    Article  Google Scholar 

  15. Cauley J (2006) Osteoporosis in men: prevalence and investigation. Clin Cornerstone 8:S20–S25

    Article  Google Scholar 

  16. Saeedi M, Al-Amri F, Mohamed A, Ibrahim A (2014) Knowledge, attitude and practice towards osteoporosis among primary health care physicians in Riyadh, Saudi Arabia. Sci J Public Health 2:624–630

    Google Scholar 

  17. Nutz A, Bastide S, Flaisler F et al (2018) AB0986 Management of osteoporosis after major fracture in a cohort of women aged over 50 in a real life setting. Ann Rheum Dis 77:1615

    Google Scholar 

  18. Liu R, Chao A, Wang K et al (2018) Incidence and risk factors of medical complications and direct medical costs after osteoporotic fracture among patients in China. Arch Osteoporos 13:12

    Article  Google Scholar 

  19. Gonnelli S, Caffarelli C, Iolascon G et al (2017) Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multi-centre Italian survey. Aging Clin Exp Res 29:1031–1037

    Article  Google Scholar 

  20. Wang P, Li Y, Zhuang H et al (2018) Influence of bone densitometry on the anti-osteoporosis treatment after fragility hip fracture. Aging Clin Exp Res. https://doi.org/10.1007/s40520-018-1094-7

    Article  PubMed  PubMed Central  Google Scholar 

  21. Al-Saleh Y, Sulimani R, Sabico S et al (2015) 2015 Guidelines for osteoporosis in Saudi Arabia: recommendations from the Saudi Osteoporosis Society. Ann Saudi Med 35:1–12

    Article  Google Scholar 

  22. Nurmi-Luthje I, Luthje P, Kaukonen J (2009) Post-fracture prescribed calcium and vitamin D supplements alone or, in females, with concomitant anti-osteoporotic drugs is associated with lower mortality in elderly hip fracture patients: a prospective analysis. Drug Aging 26:409–421

    Article  CAS  Google Scholar 

  23. Alsuwadia AO, Farag YM, Al Sayyari AA et al (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34:814–818

    PubMed  Google Scholar 

  24. Sadat-Ali M, Al Elq AH, Al-Turki HA et al (2011) Influence of vitamin D levels on bone mineral density and osteoporosis. Ann Saudi Med 31:602–608

    Article  Google Scholar 

  25. Frisch N, Wessell N, Charters M et al (2018) Hip fracture mortality: differences between intertrochanteric and femoral neck fractures. J Surg Orthop Adv 27:64–71

    Article  Google Scholar 

  26. Boylan M, Riesgo A, Paulino C et al (2018) Mortality following periprosthetic proximal femoral fractures versus native hip fractures. J Bone Jt Surg Am 100:578–585

    Article  Google Scholar 

  27. Riska B, Forsén L, Omsland T et al (2018) Does the association of comorbidity with 1-Year mortality after hip fracture differ according to gender? The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). J Am Geriatr Soc 66:553–558

    Article  Google Scholar 

  28. Yee D, Fang C, Lau T et al (2017) Seasonal variation in hip fracture mortality. Geriatr Orthop Surg Rehabil 8:49–53

    Article  Google Scholar 

  29. Kiadaliri A, Rosengren B, Englund M (2018) Fracture-related mortality in Southern Sweden: a multiple cause of death analysis, 1998–2014. Injury 49:236–242

    Article  Google Scholar 

  30. Haleem S, Lutchman L, Mayahi R et al (2008) Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 39:1157–1163

    Article  CAS  Google Scholar 

  31. Jantzen C, Madsen C, Lauritzen J et al (2018) Temporal trends in hip fracture incidence, mortality, and morbidity in Denmark from 1999 to 2012. Acta Orthop 89:170–176

    Article  Google Scholar 

Download references

Acknowledgements

The authors are thankful for the Researchers Supporting Group (RSP-2019/21) in King Saud University, Riyadh, Saudi Arabia for their assistance.

Funding

The study received no funding.

Author information

Authors and Affiliations

  1. College of Medicine, King Saud Bin Abdulaziz University and King Abdullah International Medical Research Center, Riyadh, 11425, Saudi Arabia

    Yousef Al Saleh

  2. King Abdullah International Medical Research Center, Riyadh, 11426, Saudi Arabia

    Yousef Al Saleh, Mead E. Ruhaiyem, Fatimah Al Sayed, Abeer Alkhairy, Sarah Al Zaid & Osama Al Sayed

  3. Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Yousef Al Saleh & Mohammed E. El Seid

  4. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Soad Salih

  5. Chair for Chronic Diseases, College of Science, King Saud University, Riyadh, Saudi Arabia

    Yousef Al Saleh & Nasser M. Al-Daghri

Authors
  1. Yousef Al Saleh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammed E. El Seid
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mead E. Ruhaiyem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fatimah Al Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abeer Alkhairy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sarah Al Zaid
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Osama Al Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Soad Salih
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nasser M. Al-Daghri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yousef Al Saleh.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board of King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia (IRB Ref # SP14/055).

Statement of human and animal rights

The authors confirm that procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation.

Informed consent

Not applicable in the present study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al Saleh, Y., El Seid, M.E., Ruhaiyem, M.E. et al. Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Arabia. Aging Clin Exp Res 32, 1689–1695 (2020). https://doi.org/10.1007/s40520-019-01377-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-019-01377-2

Keywords

Search

Navigation