TY - JOUR
T1 - Prevalence of undisclosed osteoporosis in patients with minimal trauma fractures
T2 - a prospective cohort study.
AU - SCARVELL, Jennie
AU - Van Twest, Melanie S.
AU - Stanton, Sonia F.
AU - Buirski, Graham
AU - Smith, Paul N.
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - Early medical intervention
KW - Fragility fracture
KW - Minimal trauma fracture
KW - Osteoporosis
UR - http://www.scopus.com/inward/record.url?scp=84883000817&partnerID=8YFLogxK
U2 - 10.3810/psm.2013.05.2011
DO - 10.3810/psm.2013.05.2011
M3 - Article
C2 - 23703516
SN - 0091-3847
VL - 41
SP - 38
EP - 43
JO - Physician and Sportsmedicine
JF - Physician and Sportsmedicine
IS - 2
ER -