Jul 2026· International Journal of Pharmaceutical Quality Assurance· Vol 16· 0 citations· 13 references
TL;DR
Osteoporotic fractures predominantly affect elderly females, mainly involving the hip and vertebrae, and are primarily caused by low-energy trauma.
Abstract
Background: Osteoporotic fractures are a major public health concern among geriatric patients, leading to
significant morbidity, mortality, and loss of independence. Understanding their prevalence and determinants is
crucial for effective prevention and management.
Aim: To determine the prevalence and identify the key determinants of osteoporotic fractures in elderly patients
admitted to a tertiary care hospital.
Methodology: A hospital-based cross-sectional study was conducted over 12 months (January 2022 to December
2022) in the Department of Orthopaedics, Sheikh Bhikhari Medical College and Hospital, Hazaribagh, Jharkhand,
India. Ninety patients aged ≥65 years with radiologically confirmed osteoporotic fractures were enrolled.
Demographic, clinical, and radiological data were collected. Logistic regression was used to identify independent
determinants.
Results: The majority of participants were females (57.8%) and from rural areas (67.8%). Hip fractures were most
common (37.8%), followed by vertebral fractures (24.4%). Low-energy falls accounted for 62.2% of fractures.
Significant determinants included age ≥75 years (OR=2.14), female gender (OR=1.86), history of previous
fracture (OR=2.72), physical inactivity (OR=1.95), and vitamin D deficiency (OR=2.38; all p<0.05).
Conclusion: Osteoporotic fractures predominantly affect elderly females, mainly involving the hip and vertebrae,
and are primarily caused by low-energy trauma. Early identification and targeted preventive strategies addressing
both modifiable and non-modifiable risk factors are essential to reduce fracture incidence and associated
healthcare burden.
Elderly spinal fracture patients, particularly men and those with multiple vertebral fractures, are at an increased risk of spinal cord injury, associated fractures, prolonged hospitalization, and mortality.
Somayae Abdollahi Sabet, Roya Khodaei· Bulletin of Emergency and Tr...· 0 citations
Background: Geriatric trauma centers (ATZ) in Germany provide interdisciplinary care for elderly trauma patients with the objective of enhancing treatment outcomes following proximal femur fractures. Delirium, a prevalent and grave complication in this patient population, has been associated with elevated mortality and functional limitations. The objective of this study was to examine the prevalence and consequences of delirium in proximal femur fractures by utilizing the Registry for Geriatric Trauma (ATR-DGU). Methods: The study encompassed 32,934 patients aged ≥70 years who sustained proximal femoral fractures during the period 2022–2023. The demographic and clinical parameters, fracture type, time of surgery, mobility, complications, and mortality were meticulously documented. The primary endpoint of the study was the occurrence of delirium and its influence of the outcome of hip fracture patients. Additionally an analysis was conducted to account for peri-implant/periprosthetic fractures. Results: Of the 21,127 patients who underwent screening, 23.6% had already been diagnosed with delirium upon admission. The delirium rate did not differ between hip-/pertrochanteric and peri-implant/periprosthetic fractures. Patients in a delirious state were found to be older, frailer, and more dependent on care. They exhibited more non-surgical complications, poorer mobility, and more frequent transfers to nursing homes. In the context of peri-implant/periprosthetic fractures, delirium showed no significant difference regarding surgical revision (p = 0.192) and mortality rates (p = 0.229). Conclusions: Delirium is therefore a prevalent and clinically significant complication. Its early detection and prevention are essential for proximal femur fracture patients in orthogeriatric care.
V. Ketter, B. Buecking, D. Eschbach et al.· Journal of Clinical Medicine· 0 citations
INTRODUCTION
Osteoporotic vertebral fractures (OVFs) are a major cause of morbidity in older adults, leading to pain, disability, and decreased quality of life. Although osteoporosis is traditionally associated with women, men also experience substantial morbidity and mortality after fractures. However, the mechanisms underlying sex differences in OVF remain unclear. This study aimed to investigate sex differences in comorbidities, bone mineral density (BMD), nutritional status, and MRI findings in patients with OVF.
METHODS
We retrospectively analyzed 492 patients (126 men and 366 women) hospitalized for OVF between 2015 and 2021. Clinical data, including comorbidities, BMD, Prognostic Nutritional Index (PNI), and MRI signal patterns, were collected. MRI patterns were classified into low- and high-risk groups for delayed bone union. Multivariate logistic regression analysis was performed to identify independent factors associated with high-risk MRI patterns.
RESULTS
Men had a significantly higher prevalence of cardiac, renal, and brain disorders, as well as malignancy, compared with women. Men also had significantly higher BMD but lower PNI values. High-risk MRI patterns were more frequent in men in univariate analysis (41.3% vs. 30.0%, p = 0.039). However, multivariate logistic regression analysis revealed that PNI was independently associated with high-risk MRI patterns (OR 0.943 per point increase, 95% CI 0.902-0.986, p = 0.0098), whereas sex was not.
CONCLUSIONS
Poor nutritional status was independently associated with high-risk MRI patterns in patients with OVF. The observed sex differences in acute radiological risk may be partially explained or mediated by differences in baseline nutritional status rather than biological sex itself.
Tatsuya Yasuda, Junichiro Sarukawa, Kaoru Yamazaki et al.· Journal of Orthopaedic Scien...· 0 citations
Background: The aging population in Thailand is rapidly increasing, leading to a rise in elderly trauma cases. Understanding the epidemiology, causes, complications, and outcomes of geriatric trauma is crucial for improving care and developing preventive strategies.
Objective: To analyze the epidemiological patterns, causes, complications, and outcomes of elderly trauma patients, and to assess the relationship between the Geriatric Trauma Outcome Score (GT OS) and mortality.
Materials and Methods: This retrospective study included 466 patients aged 60 years and older who were diagnosed with trauma between 2011 and 2021 at Chiang Mai University Hospital. Medical records were retrospectively reviewed, and data were extracted between September 2022 and July 2023. Statistical analyses included descriptive statistics, Fisher’s exact test, Student’s t-test, and univariable and multiple risk regression analyses.
Results: The majority of patients were over 65 years old (77.68%) and male (51.93%). Falls (62.66%) and traffic accidents (24.68%) were the main causes of injury. The mortality rate was 3.43%. Pneumonia (RR 1.54, 95% CI 1.02 to 2.33, p=0.040) and failed or difficult intubation (RR 1.81, 95% CI 1.15 to 2.85, p=0.010) were significant predictors of mortality. GT OS showed good predictive ability for mortality (AUC 0.807, 95% CI 0.73 to 0.88). Factors associated with high GT OS included age >65 years, ISS >15, and blood transfusion.
Conclusion: Falls are the primary cause of injury in elderly patients, with a significant impact on mortality. GT OS is an effective tool for predicting mortality in this population. Prevention strategies need to focus on fall prevention, and care protocols should address the specific needs of elderly trauma patients.
K. Chandacham, Pornsinn Koonsinn, Supaporn Rattanasiri et al.· Journal of the Medical Assoc...· 0 citations
Purpose The aim of our study is to identify the factors that influence hip fracture surgery in elderly patients within 48 hours of hospital admission. Materials and Methods We retrospectively reviewed hip fracture databases of patients who underwent surgery for hip fracture between 2020 and 2023. We excluded patients with pathological fractures, coronavirus disease 2019 infection, multiple traumas, and who died without undergoing surgery. The final study cohort included 452 patients with hip fractures. From the total participants, 201 patients underwent hip surgery within 48 hours of admission. For data analysis, we performed multivariate logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) for each variable. A P<0.05 was considered statistically significant. Results Multivariate logistic regression analysis revealed that lack of pretreatment with P2Y12 inhibitors (adjusted OR 3.23, 95% CI 1.41-7.41), absence of hematological disorders (adjusted OR 3.53, 95% CI 1.35-9.23), and absence of urinary tract infections (UTI) (adjusted OR 9.59, 95% CI 1.21-75.71) in geriatric patients with hip fracture were conducive to early surgery. Conclusion Lack of pretreatment with P2Y12 inhibitors, absence of hematological disorders, and absence of UTI were factors that influenced the timing of hip fracture surgery within 48 hours of admission.
Akkasil Pinchumponsang, Athip Kongklam, Sutee Thaveepunsan et al.· Hip & Pelvis· 0 citations
OBJECTIVE
To evaluate the in-hospital clinical and pharmacological factors predicting mortality and functional outcome at 120 days in an expanded cohort of older adults with hip fracture, analyzing the impact of de novo institutionalization and the role of longitudinal follow-up from Primary Care (PC).
MATERIAL AND METHODS
A prospective, longitudinal, observational study was conducted on a cohort of 340 patients aged ≥ 75 years admitted for a hip fracture. Clinical (established delirium, GLIM malnutrition), pharmacological (vitamin D supplementation, antiresorptive treatment), functional, and social variables were evaluated. Follow-up at 30 and 120 days was conducted from Primary Care. Bivariate analysis and multivariate logistic regression were performed.
RESULTS
The mean age was 88.3 years (73.8% women; n=251). The incidence of established delirium was 2.6% (n=9), and 52.9% (n=180) presented moderate/severe malnutrition. Pharmacologically, 2.6% (n=9) of patients were receiving prior antiresorptive treatment, compared to 31.8% (n=108) supplemented with vitamin D. Overall mortality at 120 days was 17.0% (n=55). Lethality was significantly higher in patients with delirium (66.7% vs. 15.6%; p<0.001) and malnutrition (26.1% vs. 6.2%; p<0.001). In bivariate analysis, baseline vitamin D supplementation was associated with lower medium-term mortality (9.5% vs. 20.5%; p=0.021); however, in the multivariate model, this effect lost independent significance (OR 0.51; 95% CI 0.24-1.10; p=0.085) compared to the weight of clinical comorbidities. A total of 41.5% (n=49) of previously autonomous community-dwelling survivors required de novo institutionalization.
CONCLUSIONS
In-hospital clinical complications determine medium-term vital decline. In post-discharge therapeutic adequacy, the analysis of osteoprotective therapy underscores the need for an individualized and coordinated clinical review, assuming that controlling frailty factors is a priority to prevent clinical failure and definitive institutionalization of older adults.
J. C. Miyares, J. A. Vega Álvarez, J. F. Fuertes· Semergen· 0 citations
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