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Frailty and osteoporosis in patients with hip fractures under the age of 60-a prospective cohort of 218 individuals

Strøm Rönnquist, Sebastian LU orcid ; Viberg, Bjarke ; Kristensen, Morten Tange LU ; Palm, Henrik ; Jensen, Jens-Erik Beck ; Madsen, Carsten Fladmose ; Åkesson, Kristina E LU ; Overgaard, Søren and Rogmark, Cecilia LU (2022) In Osteoporosis International 33(5). p.1037-1055
Abstract

Research on younger patients with hip fractures is limited. This study adds knowledge on patient and injury characteristics, and DXA was investigated at the time of the fracture. Risk factors for osteoporosis and fractures were numerous among young patients, and osteoporosis was markedly more prevalent than in the general population.

INTRODUCTION: Knowledge on younger patients with hip fractures is limited. Common preconceptions are that they suffer fractures due to high-energy trauma, alcohol or substance use disorder but not associated to osteoporosis. We aimed to descriptively analyze the characteristics of young and middle-aged patients with hip fractures and examine bone mineral density (BMD) by dual-energy x-ray... (More)

Research on younger patients with hip fractures is limited. This study adds knowledge on patient and injury characteristics, and DXA was investigated at the time of the fracture. Risk factors for osteoporosis and fractures were numerous among young patients, and osteoporosis was markedly more prevalent than in the general population.

INTRODUCTION: Knowledge on younger patients with hip fractures is limited. Common preconceptions are that they suffer fractures due to high-energy trauma, alcohol or substance use disorder but not associated to osteoporosis. We aimed to descriptively analyze the characteristics of young and middle-aged patients with hip fractures and examine bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) at the time of the fracture.

METHODS: A prospective multicenter cohort study on adult patients with hip fractures below age 60 collected detailed information on patient characteristics regarding demographics, trauma mechanism, previous fractures, comorbidity and medication, and lifestyle factors. DXA results were compared to population-based reference data.

RESULTS: The cohort contains 91 women and 127 men, median age 53 (IQR 47-57). Most fractures, 83%, occurred in patients aged 45-59. Two-thirds of all fractures resulted from low-energy trauma. Half of the patients had prior fractures after age 20. Thirty-four percent were healthy, 31% had one previous disease, and 35% had multiple comorbidities. Use of medication associated with increased fracture risk was 32%. Smoking was prevalent in 42%, harmful alcohol use reported by 29%, and signs of drug-related problems by 8%. Osteoporosis according to WHO criteria was found in 31%, osteopenia in 57%, and normal BMD in 12%.

CONCLUSION: In patients with hip fractures below age 60, risk factors for osteoporosis and fractures were numerous. Moreover, the prevalence of osteoporosis was markedly higher than in the general population. We suggest that young and middle-aged patients with hip fractures undergo a thorough health investigation including DXA, regardless of trauma mechanism.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Osteoporosis International
volume
33
issue
5
pages
1037 - 1055
publisher
Springer
external identifiers
  • pmid:35029719
  • scopus:85123103918
ISSN
1433-2965
DOI
10.1007/s00198-021-06281-y
language
English
LU publication?
yes
id
1c322413-c77c-403d-b0a4-a4fd60ff21ec
date added to LUP
2022-02-18 15:31:16
date last changed
2024-06-13 10:46:38
@article{1c322413-c77c-403d-b0a4-a4fd60ff21ec,
  abstract     = {{<p>Research on younger patients with hip fractures is limited. This study adds knowledge on patient and injury characteristics, and DXA was investigated at the time of the fracture. Risk factors for osteoporosis and fractures were numerous among young patients, and osteoporosis was markedly more prevalent than in the general population.</p><p>INTRODUCTION: Knowledge on younger patients with hip fractures is limited. Common preconceptions are that they suffer fractures due to high-energy trauma, alcohol or substance use disorder but not associated to osteoporosis. We aimed to descriptively analyze the characteristics of young and middle-aged patients with hip fractures and examine bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) at the time of the fracture.</p><p>METHODS: A prospective multicenter cohort study on adult patients with hip fractures below age 60 collected detailed information on patient characteristics regarding demographics, trauma mechanism, previous fractures, comorbidity and medication, and lifestyle factors. DXA results were compared to population-based reference data.</p><p>RESULTS: The cohort contains 91 women and 127 men, median age 53 (IQR 47-57). Most fractures, 83%, occurred in patients aged 45-59. Two-thirds of all fractures resulted from low-energy trauma. Half of the patients had prior fractures after age 20. Thirty-four percent were healthy, 31% had one previous disease, and 35% had multiple comorbidities. Use of medication associated with increased fracture risk was 32%. Smoking was prevalent in 42%, harmful alcohol use reported by 29%, and signs of drug-related problems by 8%. Osteoporosis according to WHO criteria was found in 31%, osteopenia in 57%, and normal BMD in 12%.</p><p>CONCLUSION: In patients with hip fractures below age 60, risk factors for osteoporosis and fractures were numerous. Moreover, the prevalence of osteoporosis was markedly higher than in the general population. We suggest that young and middle-aged patients with hip fractures undergo a thorough health investigation including DXA, regardless of trauma mechanism.</p>}},
  author       = {{Strøm Rönnquist, Sebastian and Viberg, Bjarke and Kristensen, Morten Tange and Palm, Henrik and Jensen, Jens-Erik Beck and Madsen, Carsten Fladmose and Åkesson, Kristina E and Overgaard, Søren and Rogmark, Cecilia}},
  issn         = {{1433-2965}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{5}},
  pages        = {{1037--1055}},
  publisher    = {{Springer}},
  series       = {{Osteoporosis International}},
  title        = {{Frailty and osteoporosis in patients with hip fractures under the age of 60-a prospective cohort of 218 individuals}},
  url          = {{http://dx.doi.org/10.1007/s00198-021-06281-y}},
  doi          = {{10.1007/s00198-021-06281-y}},
  volume       = {{33}},
  year         = {{2022}},
}