The management of osteoporosis in hospitalized patients with fragility hip fractures in western Saudi Arabia: a real-world tertiary center experience

Abstract

Summary

Osteoporotic fractures, especially fragility hip fractures, are major causes of mortality and morbidity in the elderly. There is a significant gap in the diagnosis and treatment of osteoporosis in patients with fragility fractures. Vitamin D use increased by 18.2% post-admission, while calcium use rose by 21.1%. Additionally, the prescription of bisphosphonates, an osteoclast inhibitor, increased by 1.2% post-admission. The study highlights the urgent need for improved management practices and more proactive care strategies to address osteoporosis and its complications.

Introduction

Osteoporotic fractures are a major cause of fragility hip fractures, and in Saudi Arabia, the high prevalence of osteoporosis and high costs highlight the need for comprehensive care. This study aimed to evaluate the management of osteoporosis in hospitalized patients with fragility hip fractures in western Saudi Arabia.

Methods

This retrospective cohort study examined medical records from individuals with fragility hip fractures at King Abdulaziz Medical City in Saudi Arabia, Jeddah, from 2004 to 2024. Data was collected from electronic health records, including demographics, clinical features, comorbidities, fall history, osteoporosis diagnosis, and medication usage.

Results

The study included 314 patients, with a mean age of 73 years and 31.2% being between 71 and 80 years old. The majority were females, with a mean BMI of 26.6 kg/m². The most common comorbidity was renal failure. The prevalence of pre-admission diagnosis of osteoporosis was 14%. Post-admission DEXA-BMD use was reported by 16.6%. Vitamin D (41.1%) and calcium (42.4%) were higher in post-admission management compared to pre-admission management.

Conclusion

The study found that most hospitalized patients with fragility hip fractures were female, overweight, had a history of falls, and suffered from renal failure. This study opens new areas for future research that could increase our understanding of osteoporosis management.