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, Montserrat Barceló Internal Medicine Department , Geriatric Unit, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain Departament de Medicina, Universitat Autònoma de Barcelona , Barcelona , Spain Address correspondence to: Montserrat Barceló, Internal Medicine Department, Geriatric Unit, Hospital de la Santa Creu i Sant Pau, Mas Casanovas street n° 90, 08041 Barcelona, Spain. Tel: 34 935565609; Fax: 34 93 556 59 38; Email: mbarcelot@santpau.cat Search for other works by this author on: Oxford Academic Jordi Casademont Departament de Medicina, Universitat Autònoma de Barcelona , Barcelona , Spain Internal Medicine Department, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain Search for other works by this author on: Oxford Academic Jordi Mascaró Internal Medicine Department , Geriatric Unit, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain Departament de Medicina, Universitat Autònoma de Barcelona , Barcelona , Spain Search for other works by this author on: Oxford Academic Ignasi Gich CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain Department of Clinical Epidemiology and Public Health, HSCSP Sant Pau Biomedical Research Institute (IIB Sant Pau) , Barcelona , Spain Search for other works by this author on: Oxford Academic Olga Herminia Torres Internal Medicine Department , Geriatric Unit, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain Departament de Medicina, Universitat Autònoma de Barcelona , Barcelona , Spain Search for other works by this author on: Oxford Academic
Age and Ageing, Volume 53, Issue 6, June 2024, afae118, https://doi.org/10.1093/ageing/afae118
Published:
20 June 2024
Article history
Received:
05 March 2024
Revision requested:
09 May 2024
Published:
20 June 2024
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Montserrat Barceló, Jordi Casademont, Jordi Mascaró, Ignasi Gich, Olga Herminia Torres, Should patients with exceptional longevity be treated for osteoporosis after a hip fracture?, Age and Ageing, Volume 53, Issue 6, June 2024, afae118, https://doi.org/10.1093/ageing/afae118
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Abstract
Background
There are no studies focusing on treatment for osteoporosis in patients with exceptional longevity after suffering a hip fracture.
Objective
To assess the advisability of initiating treatment for osteoporosis after a hip fracture according to the incidence of new fragility fractures after discharge, risk factors for mortality and long-term survival.
Design
Retrospective review.
Setting
A tertiary university hospital serving a population of ~425000 inhabitants in Barcelona.
Subjects
All patients >95years old admitted with a fragility hip fracture between December 2009 and September 2015 who survived admission were analysed until the present time.
Methods
Pre-fracture ambulation ability and new fragility fractures after discharge were recorded. Risk factors for 1-year and all post-discharge mortality were calculated with multivariate Cox regression. Kaplan–Meier survival curve analyses were performed.
Results
One hundred and seventy-five patients were included. Median survival time was 1.32years [95% confidence interval (CI) 1.065–1.834], with a maximum of 9.2years. Male sex [hazard ratio (HR) 2.488, 95% CI 1.420–4.358] and worse previous ability to ambulate (HR 2.291, 95% CI 1.417–3.703) were predictors of mortality. After discharge and up to death or the present time, 10 (5.7%) patients had a new fragility fracture, half of them during the first 6months.
Conclusions
Few new fragility fractures occurred after discharge and half of these took place in the first 6months. The decision to start treatment of osteoporosis should be individualised, bearing in mind that women and patients with better previous ambulation ability will have a better chance of survival.
mortality, hip fracture, centenarians, treatment of osteoporosis, older people
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Subject
Falls and Bone Health
Issue Section:
Research Paper
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