Treatment of osteoporosis after hip fracture is associated with lower all-cause mortality:​ a nationwide population study

Tai, Ta-Wei; Li, Chia-Chun; Huang, Chun-Feng; Chan, Wing P.; Wu, Chih-Hsing

Affiliations

¹Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

²Skeleton Materials and Biocompatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

³Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

⁴Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, I-Lan, Taiwan

⁵Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

⁶Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

⁷Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Abstract and keywords

Purpose: Mortality after osteoporotic hip fractures is high. Postoperative care is as important as surgery itself to prevent a second fracture and improve outcomes, and the effect of anti-osteoporosis treatment after hip fractures on overall mortality is controversial. This nationwide population study aimed to determine whether anti-osteoporosis treatment might reduce overall mortality after hip fracture surgery.

Methods: We conducted this cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to identify patients admitted for surgery due to hip fractures from 2008 to 2018. The subsequent use and duration of anti-osteoporotic medication and other parameters were analyzed, and national death registration records were retrieved to investigate mortality.

Results: A total of 59,943 patients admitted for hip fracture surgery were identified. The 22,494 patients (37.5%) who received anti-osteoporotic medication showed a lower all-cause mortality rate compared with the 37,449 patients (62.5%) who did not receive further treatment (hazard ratio (HR): 0.69, 95% confidence interval (CI): 0.67–0.70, p < 0.0001). Patients who received anti-osteoporotic medication for more than 1, 2, and 3 years exhibited propotional reductions in all-cause mortality (HR & 95%CI: 0.57 (0.54–0.60), 0.42 (0.38–0.46), and 0.29 (0.26–0.33) respectively).

Conclusion: Anti-osteoporosis treatment was associated with lower all-cause mortality after hip fracture surgery. A longer duration of treatment was also associated with lower mortality. Postoperative treatment for osteoporosis is crucial for patients with hip fracture.

Keywords: Hip fracture; Osteoporosis; Mortality

Links

DOI: 10.1016/j.bone.2021.116216

PubMed: ID34571203

WoS: 000703972800014

History

Received: 2021-05-16

Revised: 2021-09-11

Accepted: 2021-09-21

Online: 2021-09-25

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