Survival rate after osteoporotic proximal femur fractures

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Published Dec 1, 2024
https://doi.org/10.62438/tunismed.v102i12.5178
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Vol. 102 No. 12 (2024): Tunis Med dec 2024

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Saoussen Zrour
Rheumatology Department, Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir, University of Monastir, Tunisia
Siwar Belhaj Salem
Orthopaedic Department, Fattouma Bourguiba Hospital, Monastir Faculty of Medicine, University of Monastir, Tunisia
Narimane Ben Chekaya
Rheumatology Department, Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir, University of Monastir, Tunisia
Rim Grassa
Rheumatology Department, Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir, University of Monastir, Tunisia
Ismail Bejia
Rheumatology Department, Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir, University of Monastir, Tunisia
Abderazek Abid
Orthopaedic Department, Fattouma Bourguiba Hospital, Monastir Faculty of Medicine, University of Monastir, Tunisia

Abstract

Objectives : To evaluate survival after osteoporotic fractures of the upper femur and determine its associated factors.


Methods : Cross-sectional study of patients hospitalized for fractures of the upper end of the femur during 2020 at Monastir University Hospital. Outcome was determined up to 2 years. The Kaplan-Meier curve is used for survival analysis. 


Results : Eighty one patients with mean age of 77.46 ± 17,36 years and a sex ratio of 0.61 were evaluated. The femoral neck fracture was observed in54% of cases. Overall survival was 84.6% at 6 months, 75.4% at 1 year and 63.4% at 2 years. Median survival was 30 months. Patients older than 75 years had a shorter survival (68% versus 83% at one year and 55% versus 72% at 2 years ; p < 10-3).


Conclusion : The osteoporotic fracture of the upper femur is serious due to its severe outcome. One-year mortality was aboutt 25%. Increased mortality was associated to elderly population.


 

Keywords:

Proximal femoral fractures , osteoporosis, survival rate , mortality, elderly

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References

  1. Lorentzon M, Cummings SR. Osteoporosis: the evolution of a diagnosis. J Intern Med. 2015 ; 277(6) : 650‑61.
  2. Hernlund E, Svedbom A, Ivergård M et al. Osteoporosis in the EuropeanUnion:medical management, epidemiology and economic burden. Arch Osteoporos. 2013 ; 8 :136.
  3. Cosman F, de Beur SJ, LeBoff MS et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis.Osteoporos Int. 2014 ; 25(10) : 2359‑81.
  4. Wylie CD. Setting a standard for a “silent” disease : defining osteoporosis in the 1980s and 1990s. Stud Hist Philos Sci Part C Stud Hist Philos Biol BiomedSci. 2010 ; 41(4) : 376‑85.
  5. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ. Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury. 2008 ; 39(10) : 1157‑63.
  6. Shan-Fu Yu, Jur-Shan Cheng, Ying-Chou Chen et al. Adherence to anti-osteoporosis medication associated with lower mortality following hip fracture in older adults : a nation wide propensity score-matched cohort. BMC Geriatr. 2019 ;19(1) : 290.
  7. Sellami S, Sahli H, Meddeb N, et al. Prévalence des fractures ostéoporotiques chez la femme tunisienne. Rev Chir Orthop Reparatrice Appar Mot. 2006 ; 92 :490-4.
  8. Kuo TR, Chen CH. Bone biomarker for the clinical assessment of osteoporosis : recent developments and future perspective. BiomarkRes. 2017 ; 5(1) :18.
  9. Minisola S, Cipriani C, Occhiuto M, Pepe J. New anabolic therapies for osteoporosis. InternEmerg Med. 2017 ;12(7) : 915‑21.
  10. Salari N, Ghasemi H, Mohammadi L et al. The global prevalence of osteoporosis in the world:acomprehensivesystematicreview and meta-analysis. J OrthopSurg. 2021 ; 16 :609.
  11. Ben Abdelaziz A, Nouira S, Triki MA et al. Hip fracture in Central-EasternTunisia : epidemiology and care pathway in 2018. Tun Orthop. 2022 ; 10 (1) : 44‑65.
  12. Guzon-Illescas O, Perez Fernandez E, Crespí Villarias N et al. Mortality after osteoporotic hip fracture : incidence, trends, and associated factors. J Orthop Surg. 2019 ; 14(1) : 203.
  13. Wang CB, Lin CFJ, Liang WM et al. Excess mortality after hip fracture among the elderly in Taiwan : a nation wide population-based cohort study. Bone. 2013 ; 56(1) :147‑53.
  14. Mnif H, Koubaa M, Zrig M, Trabelsi R, Abid A. Elderly patient’s mortality and morbidity following trochanteric fracture. A hundred cases prospective study. Orthop Traumatol Surg Res. 2009 ; 95(7) :505‑10.
  15. Bouché P-A, Corsia S, Biau D et al. Does delayed weight bearing in the surgical management of fractures of the upper end of the femur in the elderly lead to more complications? A prospective study. Orthop Traumatol Surg Res. 2022 ; 108(7):103381.
  16. Youngji K, Seung-Hoon B, Yong-Chan H. Predictive factors associated with mortality in Korean elderly patients with hip fractures. J Orthop Surg 2019 ;27(2) :1-9.
  17. Prieto-Alhambra Daniel, Reyes C, Sanz Sainz M etal. In-hospital care, complications, and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study. Arch Osteoporosis 2018 ; 13: 96 https://doi.org/10.1007/s11657-018-0515-8
  18. L Riska B S, Forsén L, Omsland T K, Søgaard A J, Meyer H E , Holvik K. 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 2018 ; 66 (3) :553-558. doi: 10.1111/jgs.15207. Epub 2018 Feb 10.
  19. Adel B. La transition démographique et la perception des problèmes de population en Tunisie. Revue Tunisienne de Sciences Sociales. 2015 ;143 :77-127.
  20. Ravensbergen WM, Blom JW, Kingston A et al. Declining daily functioning as a prelude to a hip fracture in older persons—an individual patient data meta-analysis. Age Ageing.2022 ; 51(1) : afab253.
  21. Zhang J, Dennison E, Prieto-Alhambra D. Osteoporosis epidemiology using international cohorts. Curr Opin Rheumatol.2020 ;32 (4) : 387‑93.
  22. Luebbert S, Christensen W, Finkel C, Worsowicz G. Falls in Senior Adults : Demographics, Cost, Risk Stratification, and Evaluation. Mo Med. 2022 ; 119(2) :158‑63.
  23. El Maghraoui A, Ngbanda AR, Bensaoud N, Bensaoud M, Rezqi A, Tazi MA. Age-adjusted incidence rates of hip fractures between 2006 and 2009 in Rabat, Morocco. Osteoporos Int.2013 ; 24 (4) :1267‑73.
  24. El Maghraoui A, Koumba BA, Jroundi I, Achemlal L, Bezza A, Tazi MA. Epidemiology of hip fractures in 2002 in Rabat, Morocco. Osteoporos Int. 2005 ; 16(6) :597‑602.
  25. Shah A, Hawley S, Inman DS et al. Geographical variation in surgical care and mortalityfollowing hip fracture in England : a cohort study using the National Hip Fracture Database (NHFD). Osteoporos Int.2021 ;32(10) :1989‑98.
  26. Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures : data from the Swedish fracture register. BMC Musculoskelet Disord. 2018 ; 19(1) :369.
  27. Walsh ME, Ferris H, Coughlan T et al. Trends in hip fracture care in the Republic of Ireland from 2013 to 2018 : results from the Irish Hip Fracture Database. Osteoporos Int. 2021; 32(4) :727‑36.
  28. Zhang C, Feng J, Wang S et al. Incidence of and trends in hip fracture amongadults in urbanChina: A nationwideretrospectivecohortstudy. Javaid K, éditeur. PLOS Med.2020 ;17(8).
  29. Lobersztajn A, Trémollières F. Ménopause et os. J Gynécologie Obstétrique Biol Reprod.2012 ; 41(7) :28‑32.
  30. Pech-Ciau B, Lima-Martínez E, Espinosa-Cruz G, Pacho-Aguilar C, Huchim-Lara O, Alejos-Gómez R. Fractura de cadera en el adultomayor:epidemiología y costos de la atención. Acta Ortopédica Mex. 2021 ; 35(4) :341‑7.
  31. Belgacem A, Nouira A, Soussi S. Les perceptions des femmes tunisiennes selon le modèle des croyances liées à la santé et leurs pratiques relativement à l’ostéoporose. Pan Afr Med J.2016; 23 :42.
  32. Moshayedi S, Tasorian B, Almasi-Hashiani A. The prevalence of osteoporosis in rheumatoid arthritis patient: a systematic review and meta-analysis. Sci Rep. 2022 ;12(1):15844.
  33. Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am J ObstetGynecol.2006 ;194(2) :3‑11.
  34. Pluskiewicz W, Adamczyk P, Drozdzowska B. Glucocorticoids Increase Fracture Risk and Fracture Prevalence Independently from Bone Mineral Density and Clinical Risk Factors : Results from the Gliwice Osteoporosis (GO) Study. HormMetabRes. 2022 ; 54(1) :20‑4.
  35. Demir B, Haberal A, Geyik P et al. Identification of the risk factors for osteoporosis among post menopausal women. Maturitas. 2008 ; 60 (3‑4) : 253‑6.
  36. Mei Fong Ong, Kim Lam Soh, Rosalia Saimon, Myint Wai Wai, Manfred Mortell, Kim Geok. Fall prevention education to reduce fall risk among community-dwelling older persons: A systematic review. J Nurs Manag. 2021 ; 29 :2674–2688
  37. Kanis J A, Cooper C, Rizzoli R, Reginster J-Y. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019 Jan;30(1):3-44. doi: 10.1007/s00198-018-4704-5. Epub 2018 Oct 15.
  38. Paccou J, Philippoteaux C, Cortet B, Fardellone P. Effectiveness of fracture liaison services in osteoporosis. Joint Bone Spine. 2023; 90 (5) :105574. doi: 10.1016/j.jbspin.2023.105574. Epub 2023 Apr 18.
  39. Valladales-Restrepo LF, Castro-Osorio EE, Ramírez-Osorio J et al. Characterization and effectiveness of a Fracture Liaison Services program in Colombia. Arch Osteoporos. 2023 ;18(1):124. doi: 10.1007/s11657-023-01331-w.
  40. Li N, Si L, Boonen A, van den Bergh JP, Hiligsmann M. A model-based cost-effectiveness analysis of fracture liaison services in China. Arch Osteoporos. 2022 ;17(1) :132. doi: 10.1007/s11657-022-01170-1.