AB0626 THE CHARACTERISTICS AND TREATMENT OF PATIENTS ADMITTED WITH FRAGILITY FRACTURE OF THE HIP
Authors: H. Baharuddin, R. Nasadurai, S. S. Ch’ng, Y. Z. Cheng, D. R. Ramakrishna Rao, P. A. Megat Mohamad Zainuddin, S. Sabir Husin Athar, M. Mohd Zain
Journal: Annals of the Rheumatic Diseases (2021)

Background: Hip fractures are associated with significant morbidity, mortality, loss of independence and financial burden. 1 There is a positive influence of calcium and vitamin D supplementation on the fracture-healing outcome. 2 Recent evidence supports starting bisphosphonate in the acute post-fracture period. 3 Objectives: To investigate the characteristics and treatment of patients admitted with fragility fracture of the hip. Methods: This is a retrospective study on all patients admitted with fragility fracture of the hip throughout 2018, included in the hospital registry. Data collected included patients’ characteristics, place of falls, types of fracture, in-patient surgical treatment and medical treatment prescribed up until one year follow-up. Outcome of hospitalisation were reported as alive, death and at-own-risk discharge. Continuous and categorical data were described using mean (±SD) and no of patients (%). Comparison of continuous data was performed using student t-test. Results: One-hundred and sixty-seven patients were admitted with fragility fracture of the hip. There were 44 (26.3%) male and 123 (73.7%) female patients, with a mean age of 77.1(±9.8) years. Male patients were significantly younger compared to female patients [73.1(±10.5) years vs 78.5(±9.1) years, p=0.002]. Eighty-six (51.5%) patients were Chinese, followed 57 (34.1%) Malay and 24 (14.4%) Indian patients. Chinese patients were significantly older than Malay patients [80.4(±8.2) years vs 74.6(±9.8) years, p&lt;0.001] and Indian patients [80.4(±8.2) years vs 71.0(±10.5), p&lt;0.001]. Most patients, 96 (57.5%) fell within the vicinity of their homes while the other 26 (12.7%) patients fell outside of their home. The place of fall was not documented for 45 (26.9%) patients. The types of fractures were neck of femur in 70 (41.9%), inter-trochanteric fracture in 93 (55.7%) and subtrochanteric in 4 (2.4%) patients. Of 167 patients, 100 (59.9%) patients underwent surgical treatment and 67 (40.1%) patients were treated conservatively. The prescription of calcium and vitamin D was significantly higher in female patients (Table 1). Of 167 patients, 148 (88.6%) were discharged home, 12 (7.2%) patients died during hospital admission and 7 (4.2%) patients opted for at-own-risk discharge. Table 1. Treatment prescribed to patients admitted with fragility fracture of the hip. Treatment Male, no of patients (%) Female, no of patients (%) p-value Surgery Yes (n=100) 30 (30) 70 (70) 0.209 No (n=67) 14 (20.1) 53 (79.1) Calcium Yes (n=91) 18 (19.8) 73 (80.2) 0.035 No (n=76) 26 (34.2) 50 (65.8) Vitamin D Yes (n=88) 16 (18.2) 72 (81.8) 0.011 No (n=79) 28 (35.4) 51 (64.6) Bisphosphonate Yes (n=13) 0 13 (100) NA No (n=154) 44 (28.6) 110 (71.4) Conclusion: There was a high proportion of female patients admitted with fragility fracture of the hip. Majority of patients were Chinese, who were significantly older compared to Malay and Indian patients. We found a low prescription of osteoporosis medications for patients following fragility fracture of the hip. The care of osteoporosis can be improved through multidisciplinary approach. References: [1]Schnell S, et al. The 1-Year Mortality of Patients Treated in a Hip Frature Program for Elders. Geriatr Orthop Surg Rehabil, 2010; 1: 6-14. [2]Fischer V, et al. Calcium and Vitamin D in Bone Fracture Healing and Post Traumatic Bone Turnover. European Cells and Materails, 2018; 35: 365-385. [3]Barton DW, et al. Timing of Bisphosphonate Initiation After Fracture: What Does the Data Really Say? Geriatr Orthop Surg Rehabil, 2020; 11; 1-5. Disclosure of Interests: None declared.