Burden of First Osteoporotic Hip Fracture in Spain: A Prospective, 12-Month, Observational Study

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• 作者：Jose Ramón Caeiro ; Agustí Bartra ; Manuel Mesa-Ramos…
• 关键词：Osteoporosis ; Hip fracture ; Quality of life ; Autonomy ; Cost
• 刊名：Calcified Tissue International
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：100
• 期：1
• 页码：29-39
• 全文大小：451KB
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biochemistry, general; Endocrinology; Orthopedics; Cell Biology;
• 出版者：Springer US
• ISSN：1432-0827
• 卷排序：100

文摘

The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included. Twenty-two percent of patients reported a prior non-hip low-trauma fracture, 16 % were receiving osteoporotic treatment at baseline, and 3 % had densitometry performed (1.8 % T-score ≤−2.5). Sixteen percent of patients died (women 14 %; men 25 %; p = 0.0011) during the first year. Mean hospital stay was 11.8 ± 7.9 days and 95.1 % of patients underwent surgery. Other relevant HRUs were: outpatient visits in 78 % of patients (mean 9.2 ± 9.7); walking aids, 58.7 %; rehabilitation facilities, 35.5 % (28.7 ± 41.2 sessions); and formal and informal home care, 22.2 % (49.6 ± 72.2 days) and 53.4 % (77.1 ± 101.0 h), respectively. Mean direct cost was €9690 (95 % confidence interval: 9184–10,197) in women and €9019 (8079–9958) in men. Main cost drivers were: first hospitalization episode (women €7067 [73 %]; men €7196 [80 %]); outpatient visits (€1323 [14 %]; €997 [11 %]); and home care (€905 [9 %]; €767 [9 %]). QoL and autonomy showed a marked decrease during hospitalization, not entirely recovered at 12 months (p < 0.05 vs. baseline for EQ-5D, Harris hip score and modified Barthel index). In a Spanish setting, osteoporotic hip fractures incur a high societal and economic cost, mainly due to the first hospitalization HRU, but also due to subsequent outpatient visits and home care.