Portions of these study results were presented in a poster format at the National Osteoporosis Foundation/International Osteoporosis Foundation meeting, June 2001, Chicago, Ill.
Evaluation and Management of Osteoporosis Following Hospitalization for Low-impact Fracture
Article first published online: 17 JAN 2003
Journal of General Internal Medicine
Volume 18, Issue 1, pages 17–22, January 2003
How to Cite
Simonelli, C., Chen, Y.-T., Morancey, J., Lewis, A. F. and Abbott, T. A. (2003), Evaluation and Management of Osteoporosis Following Hospitalization for Low-impact Fracture. Journal of General Internal Medicine, 18: 17–22. doi: 10.1046/j.1525-1497.2003.20387.x
- Issue published online: 17 JAN 2003
- Article first published online: 17 JAN 2003
- low-impact fracture;
- osteoporosis evaluation;
- osteoporosis treatment
OBJECTIVE: To evaluate the pattern of osteoporosis evaluation and management in postmenopausal women who present with low-impact (minimal trauma) fracture.
DESIGN: Retrospective chart review of patients admitted with a fracture in the absence of trauma or bone disease. Telephone follow-up survey was conducted at 12 months after discharge to collect information on physician visits, pharmacological therapies for osteoporosis, functional status, and subsequent fractures.
PATIENTS/PARTICIPANTS: Postmenopausal women admitted to a hospital in St. Paul, Minnesota between June 1996 and December 1997 for low-impact fractures were identified. Low-impact fracture was defined as a fracture occurring spontaneously or from a fall no greater than standing height. Retrospective review of 301 patient medical records was conducted to obtain data on pre-admission risk factors for osteoporosis and/or fracture, and osteoporosis-related evaluation and management during the course of hospitalization. Follow-up 1 year after the incident fracture was obtained on 227 patients.
MEASUREMENTS AND MAIN RESULTS: Two hundred twenty-seven women were included in the study. Osteoporosis was documented in the medical record in 26% (59/227) of the patients at hospital discharge. Within 12 months of hospital discharge, 9.6% (22/227) had a bone mineral density test, and 26.4% (60/227) were prescribed osteoporosis treatment. Of those who were prescribed osteoporosis treatment, 86.6% (52/60) remained on therapy for 1 year. Nineteen women suffered an additional fracture. Compared to women without a prior fracture, women with at least 1 fracture prior to admission were more likely to have osteoporosis diagnosed and to receive osteoporosis-related medications.
CONCLUSION: Despite guidelines that recommend osteoporosis evaluation in adults experiencing a low-trauma fracture, we report that postmenopausal women hospitalized for low-impact fracture were not sufficiently evaluated or treated for osteoporosis during or after their hospital stay. There are substantial opportunities for improvement of care in this high-risk population to prevent subsequent fractures.