OFELIA: Prevalence of Osteoporosis in Fragility Fracture Patients

Worldwide, a care gap has been recognized between presenting with a fracture and prevention of the next fracture. Fracture Liaison Service is the most cost-effective method to close this gap, but its implementation is sparse in the Nordic countries. To assess the need for a fracture prevention program, the primary aim of this study was to estimate the prevalence of osteoporosis in patients treated for fragility fractures at Aarhus University Hospital, Denmark. Secondary aims were to identify clinical risk factors associated with osteoporosis and the up-take of anti-osteoporosis treatment. The study was conducted as a cross-sectional study and patients aged 18+ years were consecutively identified over a 12 months period. Of 1164 identified patients, 832 were included and 794 (70% women, 66% aged ≥ 50 years) patients completed the study. Bone mineral density was measured by DXA and information about clinical risk factors were obtained. The overall prevalence of osteoporosis in this cohort was 14.9%, increasing to 20.3% in patients ≥ 50 years (22.9% in women, 9.6% in men). In addition to age above 50 years, female sex, low BMI, and early menopause were significantly associated with osteoporosis. At 3-years follow-up in patients diagnosed with osteoporosis, 95% of patients who initiated anti-osteoporosis treatment after their fracture were still adherent to treatment. Given that osteoporosis was demonstrated in one in five fragility fracture patients above 50 years, OFELIA stresses the need for implementation of a program aiming at securing appropriate investigation and treatment of osteoporosis in patients presenting a fragility fracture.