Osteoporosis treatment gap after hip fracture: data from a tertiary center in Turkey.

Abstract

This study investigates the osteoporosis treatment gap and mortality following hip fractures in Turkey. We found that 83.1% of patients did not receive post-fracture osteoporosis treatment, with a 1-year mortality rate of 37%. Prior treatment, younger age, and parenteral medications were significant predictors of treatment adherence. These findings highlight the urgent need to address treatment gaps and improve patient outcomes.

Objective: This study aimed to evaluate the osteoporosis treatment gap, mortality rates, and predictors of mortality in hip fracture patients in a tertiary center in Turkey.

Methods: A retrospective analysis was conducted of 552 patients aged over 50 years who were hospitalized for hip fractures at Prof. Dr. Cemil Taşcıoglu City Hospital between January 2015 and November 2022. Data were collected from electronic medical records, including pre- and post-fracture osteoporosis treatment, treatment initiation times, bone mineral density (BMD) tests, and patient outcomes.

Results: The mean age of the cohort was 80.2 years, with a predominance of female patients (65.1%). Prior to the fracture, 90.8% of patients had not received osteoporosis treatment. After the fracture, 83.1% of patients did not receive any osteoporosis medications. Of those treated, 45 patients (8.6%) started treatment within 3 months. The 1-year mortality rate was 37%, with significant predictors including age, male gender, lack of prior osteoporosis treatment, delayed treatment initiation, and short treatment duration. Only 5.6% of patients had a BMD test within the first year after the fracture, which was associated with improved treatment adherence and lower mortality.

Conclusions: The study highlights a significant treatment gap for osteoporosis in hip fracture patients in Turkey. Prior treatment history, younger age, and use of parenteral therapies were strong predictors of adherence to post-fracture osteoporosis treatment. These findings emphasize the need for improved healthcare provider awareness, better treatment initiation protocols, and the implementation of Fracture Liaison Services.