Background: Osteoporosis is a chronic disease characterised by bone fragility due to an increase in bone resorption and decrease in bone formation. This leads to an increased risk of fracture which can lead to significant morbidity and mortality. University Hospital Geelong is a large tertiary centre, servicing a catchment area of over 500,000. With an aging population, the impact of osteoporosis and related fractures are significant.
Aim: To determine the percentage of patients appropriately commenced on osteoporosis therapy as per the recommended guidelines after presenting with neck of femur fractures over a 12-month period at University Hospital Geelong.
Method: A retrospective audit was undertaken of all patients who presented to University Hospital Geelong over a 12-month period with a neck of femur fracture. The primary outcome was the number of patients appropriately commenced on osteoporosis therapy prior to or on discharge. The secondary outcome was the number of these patients readmitted over the next 12-month period with subsequent fractures.
Results: 112 patients were admitted with neck of femur fractures treated with operative management over the 12-month period. The median age was 81 years old, with 69% being female.
Only 53% (n=60) were commenced on osteoporosis therapy prior to or on discharge, with 87% of these patients being commenced on denosumab. 38% (n=20) of patients not commenced on therapy had a contraindication to current therapy. 6% (n=7) of patients were readmitted with an insufficiency fracture within 12 months, however this did not show a statistically significantly relationship with commencement of osteoporosis therapy.
Conclusion: A low percentage of patients admitted to University Hospital Geelong with a neck of femur fracture are commenced on osteoporosis therapy. This was not found to cause a statistically significant increase in readmission with fracture over the next 12 months.