Prevalence of undisclosed osteoporosis in patients with minimal trauma fractures

a prospective cohort study.

Jennie SCARVELL, Melanie S. Van Twest, Sonia F. Stanton, Graham Buirski, Paul N. Smith

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Despite epidemiologic evidence for the presence of osteoporosis in patients with minimal trauma fractures, screening programs have not been routinely established in Australian ambulatory care clinics. Our study assessed the prevalence of osteoporosis and osteopenia in patients at a tertiary care hospital to gather local data to support policy change that favors bone mineral density screening. Our prospective observational study enrolled 115 patients, aged > 40 years, who had experienced a minimal trauma fracture. Inclusion criteria required that the patient had no history of testing for osteoporosis or metabolic bone disease/major pathology. The patients were recruited over a 6-month period. Eleven participants were excluded and 7 participants withdrew from the study, with a total of 97 patients completing the study. Participants were assessed for osteoporosis risk via bone mineral density measurement by dual-energy x-ray absorptiometry and blood screening for bone mineral levels, 25-hydroxyvitamin D, and parathyroid hormone levels. In our study patients, the prevalence of previously undiagnosed osteoporosis was 19%, undiagnosed osteopenia, 50%, and the standard bone mineral density was 32%. The most common risk factors for osteoporosis/osteopenia were smoking (22%), alcohol intake (16%), and corticosteroid use (9%). In 67% of patients, 25-hydroxyvitamin D level was in the low clinical range in 51% of patients, magnesium levels were in the high range and 18% of patients had elevated serum parathyroid levels. At month 12 of our study, 80 participants were available for follow-up: 2 patients had sustained a second fracture (1 was minimal trauma); 6 patients had required further surgery (3 fracture fixations, 3 for removal of internal fixation devices); 26 patients continued treatment regimens with calcium and 25-hydroxyvitamin D supplementation; and 28 patients had been prescribed bisphosphonates, with 22 patients complying with the prescription. The high prevalence of previously undiagnosed low bone mass in our study patient population, each of whom had experienced minimal trauma falls, provides impetus for the provision of osteoporosis screening programs and corresponding treatment as needed.

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalPhysician and Sportsmedicine
Volume41
Issue number2
DOIs
Publication statusPublished - 2013

Fingerprint

Osteoporosis
Cohort Studies
Prospective Studies
Wounds and Injuries
Metabolic Bone Diseases
Bone Density
Cross-Sectional Studies
Internal Fixators
Bone and Bones
Fracture Fixation
Diphosphonates
Tertiary Healthcare
Ambulatory Care
Parathyroid Hormone
Tertiary Care Centers
Magnesium
Observational Studies
Prescriptions
Minerals
Adrenal Cortex Hormones

Cite this

SCARVELL, Jennie ; Van Twest, Melanie S. ; Stanton, Sonia F. ; Buirski, Graham ; Smith, Paul N. / Prevalence of undisclosed osteoporosis in patients with minimal trauma fractures : a prospective cohort study. In: Physician and Sportsmedicine. 2013 ; Vol. 41, No. 2. pp. 38-43.
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abstract = "Despite epidemiologic evidence for the presence of osteoporosis in patients with minimal trauma fractures, screening programs have not been routinely established in Australian ambulatory care clinics. Our study assessed the prevalence of osteoporosis and osteopenia in patients at a tertiary care hospital to gather local data to support policy change that favors bone mineral density screening. Our prospective observational study enrolled 115 patients, aged > 40 years, who had experienced a minimal trauma fracture. Inclusion criteria required that the patient had no history of testing for osteoporosis or metabolic bone disease/major pathology. The patients were recruited over a 6-month period. Eleven participants were excluded and 7 participants withdrew from the study, with a total of 97 patients completing the study. Participants were assessed for osteoporosis risk via bone mineral density measurement by dual-energy x-ray absorptiometry and blood screening for bone mineral levels, 25-hydroxyvitamin D, and parathyroid hormone levels. In our study patients, the prevalence of previously undiagnosed osteoporosis was 19{\%}, undiagnosed osteopenia, 50{\%}, and the standard bone mineral density was 32{\%}. The most common risk factors for osteoporosis/osteopenia were smoking (22{\%}), alcohol intake (16{\%}), and corticosteroid use (9{\%}). In 67{\%} of patients, 25-hydroxyvitamin D level was in the low clinical range in 51{\%} of patients, magnesium levels were in the high range and 18{\%} of patients had elevated serum parathyroid levels. At month 12 of our study, 80 participants were available for follow-up: 2 patients had sustained a second fracture (1 was minimal trauma); 6 patients had required further surgery (3 fracture fixations, 3 for removal of internal fixation devices); 26 patients continued treatment regimens with calcium and 25-hydroxyvitamin D supplementation; and 28 patients had been prescribed bisphosphonates, with 22 patients complying with the prescription. The high prevalence of previously undiagnosed low bone mass in our study patient population, each of whom had experienced minimal trauma falls, provides impetus for the provision of osteoporosis screening programs and corresponding treatment as needed.",
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Prevalence of undisclosed osteoporosis in patients with minimal trauma fractures : a prospective cohort study. / SCARVELL, Jennie; Van Twest, Melanie S.; Stanton, Sonia F.; Buirski, Graham; Smith, Paul N.

In: Physician and Sportsmedicine, Vol. 41, No. 2, 2013, p. 38-43.

Research output: Contribution to journalArticle

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