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Hantouly AT, AlBarazanji A, Al-Juboori M, Alebbini M, Toubasi AA, Mohammed A, Alzobi O, Ahmed G. Epidemiology of proximal femur fractures in the young population of Qatar. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:21-29. [PMID: 37548762 PMCID: PMC10771613 DOI: 10.1007/s00590-023-03664-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To review the epidemiological characteristics of proximal femur fractures in the young population (< 60 years) of Qatar between 2017 and 2019. METHODS All patient treated for proximal femur fractures at Hamad General Hospital (HGH), a level one trauma center, were retrospectively reviewed between Jan 2017 and Dec 2019. All adults (18-60 years) with proximal femur fracture (femur head, femur neck, intertrochanteric and subtrochanteric fractures) were included with no restriction to the AO/OTA classification or fractures subtypes. Excluded cases were pathological fractures, cases with insufficient documentation or no radiographs. RESULTS A total of 203 patients with a mean age of 40.07 ± 11.76 years were included, of who 89.9% were males. The incidence of proximal femur fracture was 3.12/100,000/year. Fall from height (48.1%) followed by road traffic accidents (26.9%) were common cause of injury. The most common fracture type was intertrochanteric fracture (36.1%) followed by femur neck fractures (33.7%). CONCLUSION This study provides the initial insights into the proximal femur fractures in the young population of Qatar. This is the first study to investigate of the epidemiology of such fractures in this particular patient group. Contrary to the existing literature on older age groups, the majority of the injuries were observed in males. Falls from height followed by road traffic accidents were the primary mechanisms leading to these fractures. Improved understanding of the profile of these injuries can aid in their prevention by implementing more effective safety measures.
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Affiliation(s)
- Ashraf T Hantouly
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Asim AlBarazanji
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Al-Juboori
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Mohanad Alebbini
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Asma Mohammed
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Osama Alzobi
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Ghalib Ahmed
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
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Baghdadi S, Kiyani M, Kalantar SH, Shiri S, Sohrabi O, Beheshti Fard S, Afzal S, Khabiri SS. Mortality following proximal femoral fractures in elderly patients: a large retrospective cohort study of incidence and risk factors. BMC Musculoskelet Disord 2023; 24:693. [PMID: 37649030 PMCID: PMC10466793 DOI: 10.1186/s12891-023-06825-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Global prevalence of osteoporosis and fragility fractures is increasing due to the aging population. Proximal femoral fractures are among the most common orthopedic conditions in elderly that significantly cause health deterioration and mortality. Here, we aimed to evaluate the mortality rates and risk factors, besides the functional outcomes after these injuries. METHODS In a retrospective cohort study, all patients admitted with a femoral neck or intertrochanteric fracture between 2016 and the end of 2018 were enrolled in this study. Medical records were reviewed to include patients over 60 years of age who had a proximal femoral fracture and had a complete medical record and radiographs. Exclusion criteria included patients with pathological fractures, cancer under active treatment, follow-up loss, and patient access loss. Demographic and clinical features of patients alongside the details of fracture and patient management were recorded and analyzed. In-hospital and post-discharge mortalities due to included types of fractures at one and 12 months were the primary outcome. Modified Harris Hip Scores (mHHS) was the measure of functional outcome. RESULTS A total of 788 patients including 412 females (52.3%) and 376 males (47.7%) with a mean age of 76.05 ± 10.01 years were included in this study. Among patients, 573 (72.7%) had an intertrochanteric fracture, while 215 (27.3%) had a femoral neck fracture, and 97.1% of all received surgical treatment. With a mean follow-up of 33.31 months, overall mortality rate was 33.1%, and 5.7% one-month and 20.2% 12-months rates. Analysis of 1-month mortality showed a significant mortality difference in patients operated after 48 h of fracture (p = 0.01) and in patients with American Society of Anesthesiologists (ASA) scores of 3-4 compared to ASA scores of 1-2 (p = 0.001). One-year mortality data showed that the mortality rate in femoral neck fractures was lower compared to other types of fracture. Surgical delay of > 48 h, ASA scores of 3-4, and treatment by proximal femoral plate were associated with shorter survival. The overall mean mHHS score was 53.80 ± 20.78. CONCLUSION We found several risk factors of mortality, including age ≥ 80 years, a > 48-hour delay to surgery, and pre-operative ASA scores of 3-4 in patients with proximal femoral fracture. Furthermore, the use of a proximal femoral plate was a significant risk factor for mortality and lower mHHS scores.
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Affiliation(s)
- Soroush Baghdadi
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maryam Kiyani
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyyed Hadi Kalantar
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, P.O. box: 1419733141, Tehran, Iran
| | - Samira Shiri
- Clinical Research Development Centre, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Omid Sohrabi
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahabaldin Beheshti Fard
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, P.O. box: 1419733141, Tehran, Iran
| | - Sina Afzal
- Department of Orthopedic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Saeed Khabiri
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, P.O. box: 1419733141, Tehran, Iran.
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Tanha K, Fahimfar N, Nematollahi S, Sajjadi-Jazi SM, Gharibzadeh S, Sanjari M, Khalagi K, Hajivalizedeh F, Raeisi A, Larijani B, Ostovar A. Annual incidence of osteoporotic hip fractures in Iran: a systematic review and meta-analysis. BMC Geriatr 2021; 21:668. [PMID: 34847861 PMCID: PMC8638533 DOI: 10.1186/s12877-021-02603-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background Osteoporosis (OP) is progressively becoming a global concern with the aging of the world’s populations. Osteoporotic fractures are associated with significantly increased mortality rates and a financial burden to health systems. This Meta-analysis aims to estimate the annual incidence of osteoporotic fractures in Iran. Methods A comprehensive systematic literature search was performed through Medline (PubMed), Embase, Scopus, Web of Science, and Google Scholar to identify studies which contain an investigation of the incidence of osteoporotic fractures in Iran up to December 3rd 2020, with no time and language restriction. For the risk of bias assessments of studies, the Joanna Briggs Institute (JBI) critical appraisal checklist for studies reporting prevalence data was used. The pooled estimation of the incidence of osteoporotic fractures in population aged≥50 years was calculated using random-effects meta-analysis, and the heterogeneity of included studies was quantified with the I2 statistic. Results In all, 6708 papers were initially retrieved from the electronic databases, among which seven studies were included in the meta-analysis. The pooled standardized annual cumulative incidence of hip fractures was estimated as 138.26 (95% CI: 98.71–193.65) per 100,000 population and 157.52 (95% CI: 124.29–199.64) per 100,000 population in men and women, respectively. Conclusion This study showed a high incidence rate of osteoporotic hip fractures in Iran. Early detection and treatment of individuals with higher risks of primary fragility fractures at primary health care as well as implementing fracture liaison services to prevent secondary fractures are highly recommended. The results suffer from the following limitations: first, a low number of studies that were eligible for inclusion; second, the lack of population-based studies; and presence of highly heterogeneous studies despite the use of a random effect model. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02603-1.
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Affiliation(s)
- Kiarash Tanha
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shahrzad Nematollahi
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Mahmoud Sajjadi-Jazi
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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George J, Sharma V, Farooque K, Mittal S, Trikha V, Malhotra R. Injury Mechanisms of Hip Fractures in India. Hip Pelvis 2021; 33:62-70. [PMID: 34141692 PMCID: PMC8190498 DOI: 10.5371/hp.2021.33.2.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 01/16/2023] Open
Abstract
Purpose Hip fractures are a major cause of morbidity and mortality in the elderly; however, the current literature on the injury patterns of hip fractures in India is lacking. Understanding the injury profile of these patients is important to develop targeted interventions to prevent hip fractures. Materials and Methods This was a prospective study of all hip fracture patients aged 50 years or older admitted from February 2019 to December 2019. Details about the injury were recorded by an in-person interview. Multivariate logistic regression analysis was used to identify the factors associated with any particular injury mechanism. Results Two hundred and eighty-three hip fractures were included. The mechanism of injury for the majority of patients was a fall from a standing height (n=217, 76.7%) while 60 patients (21.2%) were injured as the result of a road traffic accident (RTA). Slipping on a wet floor (n=49, 22.6%) and change in posture (n=35, 16.1%) were the most commonly reported reasons for falling. Pedestrian injuries were the most common form of RTA (n=29, 48.3%). Increasing age (P<0.001) and female sex (P=0.001) were associated with fall as the mode of injury while sustaining another fracture in addition to hip fracture (P=0.032) was associated with RTA as the mode of injury. Conclusion A fall from standing height is the predominant mode of injury among elderly hip fractures especially among women. Environmental hazards and postural changes are responsible for the majority of falls while pedestrian accidents contribute to a majority of the RTAs.
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Affiliation(s)
- Jaiben George
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vijay Sharma
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kamran Farooque
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Samarth Mittal
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vivek Trikha
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rajesh Malhotra
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Hadaegh F, Asgari S, Toreyhi H, Eskandari F, Fahimfar N, Bozorgmanesh M, Hosseinpanah F, Azizi F. Sex-specific incidence rates and risk factors for fracture: A 16-year follow-up from the Tehran lipid and glucose study. Bone 2021; 146:115869. [PMID: 33529827 DOI: 10.1016/j.bone.2021.115869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/06/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the population-based incidence of any-fracture and its potential risk factors in a sex-split cohort of the Iranian population. MATERIALS AND METHODS A total of 3477 men and 4085 women with a mean (SD) age of 47.92(13.1) and 45.88(11.47) years, respectively were entered into the study. The age-standardized incidence rates per 100,000 person-years were reported for the whole population and each sex separately. Cox proportional hazard models were used to estimate hazard ratios (HR) for potential risk factors. Only fractures requiring inpatients' care were considered as the outcome. We also defined major osteoporotic fractures (MOF) as the composite of the fractures that occurred in the vertebral, wrist, hip and pelvic sites among population aged ≥50 years. RESULTS During the median (IQR) follow-up of 15.9 years, 4.34%men and 3.75% women experienced at least one incident any-fracture. The annual age-standardized incidence rates (95% CI) among men and women were 330.9 (279.6-388.9) and 319.4(268.1-377.3) per 100,000 person-years, respectively; the corresponding values for incidence of MOF was 202.2(142.3-278.6) in men and 342.1(260.4-441.0) per 100,000 person-years for women. In the multivariable model, among the whole population, age groups ≥50 years, central obesity [HR: 95% CI 1.77(1.32-2.39)], current smoking [1.59(1.15-2.20)] and using steroid medications [2.20(1.04-4.67)] significantly increased the risk of incident fracture (all P < 0.05); however the impact of the first two risk factors were more prominent among women (P for interaction ≤0.01). Moreover, being obese was associated with a lower risk of incident first fracture in the total population [HR: 95% CI: 0.61(0.40-0.92)]. Being men [HR: 95% CI: 0.54(0.30-0.99)] and prediabetes status [HR: 95% CI: 0.53(0.30-0.95)] were also associated with lower risk for MOF. CONCLUSION This is the first report of long-term incidence rate of any-fracture and MOF conducted in the metropolitan city of Tehran. Among modifiable risk factors of fracture, in the whole population smoking habit and using steroid medications and particularly for women central obesity should be considered as main risk factors for preventive strategies. Prediabetes status was associated with lower risk of MOF.
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Affiliation(s)
- Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Toreyhi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Eskandari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Amouzegar A, Asgari S, Azizi F, Momenan AA, Bozorgmanesh M, Hadaegh F. The Role of Metabolic Syndrome and its Components in Incident Fracture: A 15-Year Follow-Up Among the Iranian Population. J Clin Endocrinol Metab 2021; 106:e1968-e1983. [PMID: 33522577 DOI: 10.1210/clinem/dgab023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 12/15/2022]
Abstract
CONTEXT The relationship between metabolic syndrome (MetS) and the risk of fracture is a matter of debate. OBJECTIVE This work aimed to determine the impact of MetS and its components on the risk of hospitalized fractures, during a median follow-up of 15.9 years. METHODS A total of 7,520 participants (4,068 women) 30 years or older entered the study. Multivariable Cox proportional hazards regression were applied for data analysis. RESULTS The prevalence of MetS was 40.0% and 40.4% in men and women, respectively. During the follow-up, hospitalized fracture was observed in 305 cases (men = 152). The multivariable hazard ratio (HR) and 95% confidence interval (CI) of MetS for incident fracture for men and women was 0.72 (0.49-1.05, P = .08) and 1.38 (0.96-1.98, P = .08), respectively. In the fully adjusted model, high fasting plasma glucose (FPG) among men tended to be associated with a lower risk of fracture [0.67 (0.44-1.02, P = .06)]; among women, high waist circumference (WC) was associated with a greater risk [2.40 (1.55-3.73)]. Among the population 50 years and older in the pooled sample, MetS was not accompanied by the risk of fracture, but high WC was associated with a higher risk [1.58 (1.07-2.33)]. For incident hip/pelvic fracture, abdominal obesity-but not MetS per se-was also a strong and independent risk factor. CONCLUSION A significant sex difference in the association between MetS and its components with incident fracture was observed. Women with central adiposity were at increased risk of hospitalized fracture, whereas men with high FPG were at decreased risk.
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Affiliation(s)
- Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Khashayar P, Dimai HP, Moradi N, Fahimfar N, Gharibzadeh S, Ostovar A, Nabipour I, Larijani B. Protocol for a multicentre, prospective cohort study of clinical, proteomic and genomic patterns associated with osteoporosis to develop a multidimensional fracture assessment tool: the PoCOsteo Study. BMJ Open 2020; 10:e035363. [PMID: 32998914 PMCID: PMC7528352 DOI: 10.1136/bmjopen-2019-035363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The HORIZON 2020 project PoCOsteo aims (1) to develop a multidimensional fracture risk assessment tool which would take into account all factors known to be related to an individual's fracture risk. The fracture risk model is intended to be developed in two different populations, namely a European and a Middle Eastern one; (2) to develop a medical device, which would measure and/or quantify proteomic as well as genomic factors as present in whole blood samples collected through finger prick; (3) to test the clinical applicability and the validity of prototypes of the to be developed point of care device at both clinical centres. METHODS AND ANALYSIS This article presents the protocol of this prospective cohort that will be carried out independently at two different centres (Division of Endocrinology and Diabetology at the Medical University of Graz (MUG) as a clinic-based cohort, and Endocrinology and Metabolism Research Institute (EMRI) at the Tehran University of Medical Sciences (TUMS) as a population-based cohort). The final aim is to develop a fracture risk assessment model, which would include clinical risk factors, biochemical markers of bone turnover, as well as specific genomic factors. The derivation cohorts will consist of individuals aged 50 years and above. The period of observation for each patient will be 12 months; an extension phase, which would last for another 2 years, is also planned. ETHICS AND DISSEMINATION These studies are conducted in accordance with the World Medical Association Declaration of Helsinki. The Iranian part was approved by the Research Ethics Committee of EMRI, TUMS. The Austrian part was approved by the Ethics Committee of the Medical University of Graz. Based on the gathered information, a multidimensional fracture assessment tool will be designed which will later be added to the PoCOsteo device.
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Affiliation(s)
- Patricia Khashayar
- Center for Microsystems Technology, Imec & Ghent University, Zwijnaarde - Gent, Belgium
| | - Hans Peter Dimai
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Steiermark, Austria
| | - Nahid Moradi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran (the Islamic Republic of)
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran (the Islamic Republic of)
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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Tootee A, Larijani B. World osteoporosis day: celebrating two decades of progress in preventing osteoporotic fractures in Iran. J Diabetes Metab Disord 2019; 18:725-727. [PMID: 31890697 PMCID: PMC6915240 DOI: 10.1007/s40200-019-00465-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Ali Tootee
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Khani Jeihooni A, Ghasemi M, Mobaraei AH, Jamshidi H, Afzali Harsini P. The Application of PRECEDE Model on Preventing Osteoporosis in Women. Clin Nurs Res 2019; 30:241-252. [PMID: 31434510 DOI: 10.1177/1054773819865874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is investigating the efficiency of educational intervention based on PRECEDE model on promotion of osteoporosis prevention behaviors in women. This quasi-experimental study was conducted on 200 women registered in two health centers of Fasa city, Fars province, Iran in 2017 to 2018. A questionnaire including items evaluating demographic information and PRECEDE model constructs was used for measuring nutrition and walking performance of studied women in osteoporosis prevention before and 12 months after intervention. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and 12 months after intervention. One year after intervention, the intervention group showed a significant increase in knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, nutrition, and walking performance compared to the control group. Also, the value of lumbar spine and hip BMD T-Score of the intervention group was increased, while this value was reduced in the control group. Our findings showed that educational interventions based on PRECEDE model can positively affect prevention behaviors from osteoporosis by improving subjects' knowledge, attitude, enabling factors (resources such as health care access and services that can provide motivation for prevention behaviors from osteoporosis in women), self-efficacy, and reinforcing factors.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Ghasemi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Amir Hossein Mobaraei
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Hassan Jamshidi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Maharlouei N, Jafarzadeh F, Lankarani KB. Factors affecting recovery during the first 6 months after hip fracture, using the decision tree model. Arch Osteoporos 2019; 14:61. [PMID: 31183563 DOI: 10.1007/s11657-019-0611-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 05/28/2019] [Indexed: 02/08/2023]
Abstract
UNLABELLED Pelvic fractures are one of the most common orthopedic problems that can reduce the quality of life in the elderly. In this prospective study, we found that osteoporosis, depression, and socioeconomic status were the most important factors associated with patients' recovery during the first 6 months after pelvic fracture. PURPOSE Hip fractures are one of the most common orthopedic problems that can reduce the quality of life in the elderly. Considering that, we aimed to provide a comprehensive assessment of the factors affecting recovery during the first 6 months after hip fracture. METHODS All patients with hip fracture admitted to any of the orthopedic hospitals during July 10, 2011 to July 9, 2012 in Shiraz, Iran were included in this prospective cohort study. Patients' demographic data and also information regarding their performance and mobility after hip fracture was collected in two interviews at intervals of 6 months. All analyses were done in R software and mostly by party packages and PCAmixdata package. Tree and forest models of conditional inference were used to evaluate the factors affecting the recovery after hip fracture. RESULTS Two hundred sixty-six out of 514 patients (51.75%) with hip fracture recovered completely after a 6-month follow-up period. Osteoporosis, new-onset depression after hip fracture, and socioeconomic status (SES) were the most important predictors of patients' mobility status 6 months after hip fracture. In identifying predictor variables, the conditional inference forest method provided a more appropriate fit for the data than the conditional inference tree. CONCLUSIONS Awareness of the factors that affect patients' recovery can be helpful in improving the patients' health, as well as improving care services, thereby increasing the success of treatment. Osteoporosis, new-onset depression after hip fracture, and SES were the most important factors associated with patients' recovery. Therefore, focusing on these variables is essential.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Health Policy Research Center, Building No. 2, 8th Floor, Medical School, Zand Avenue, Shiraz, Iran.
| | - Fatemeh Jafarzadeh
- Students' Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Health Policy Research Center, Building No. 2, 8th Floor, Medical School, Zand Avenue, Shiraz, Iran
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11
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Maghbooli Z, Hossein-Nezhad A, Jafarpour M, Noursaadat S, Ramezani M, Hashemian R, Moattari S. Direct costs of osteoporosis-related hip fractures: protocol for a cross-sectional analysis of a national database. BMJ Open 2017; 7:e014898. [PMID: 28400460 PMCID: PMC5775462 DOI: 10.1136/bmjopen-2016-014898] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION It is estimated that Iran accounted for about 1% of hip fracture burden of the world in 2007, but these data are based on incomplete evidence. As the country's population is ageing, it is expected that a dramatic rise in hip fracture incidence will result. There is no single national study that accurately estimates the incidence of all hip fractures in the country or identifies the direct costs for affected patients. To help fill this gap, the current study has been designed to determine the incidence of hip fracture associated with osteoporosis in the Iranian population and to assess the direct costs involved. METHODS AND ANALYSIS This is a cross-sectional analysis of 2 years of hospital admissions due to hip fracture in Iran from October 2014 to October 2016 using an electronic health record called SEPAS. SEPAS is a nationwide health information system established by Information Technology (IT) and the Statistics Department of the Ministry of Health. SEPAS has recorded more than 8.5 million inpatient hospitalizations since October 2014. Our study will identify reported hip fracture data in SEPAS among admitted adult hospital patients aged ≥50 in Iran. International Classification of Diseases ICD-9 and 10 will be used as diagnostic codes. Study factors are demographic data, types of fracture, types of treatment, duration of admission, early complications, in-hospital mortality and direct cost of fracture treatment. The accuracy of the SEPAS fracture data will be ascertained through a pilot study that compares the SEPAS data with the data directly extracted from medical records of the Shariati Hospital in Tehran during the study period. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the National Institute for Medical Research Development of Iran. Dissemination plans include academic publications, conference presentations and social media.
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Affiliation(s)
- Zhila Maghbooli
- Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Hossein-Nezhad
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Campus, Boston, Massachusetts, USA
| | - Maryam Jafarpour
- Statistics and Information Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sima Noursaadat
- Statistics and Information Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Majid Ramezani
- Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences, Tehran, Iran
| | - Roxana Hashemian
- Boston University School of Dental Medicine, Boston, Massachusetts, USA
| | - Syamak Moattari
- Department of Health Sciences, Worcester State University, Worcester, Massachusetts, USA
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12
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The Outcomes of Treating Femoral Neck Fractures Using Bipolar Hemiarthroplasty. Trauma Mon 2016. [DOI: 10.5812/traumamon.26831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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Malekshahi F, Hidarnia A, Niknami S, Aminshokravi F. The Determination of Predictive Construct of Physical Behavior Change on Osteoporosis Prevention Women Aged 30-50: A Trans-Theoretical Method Study. Glob J Health Sci 2015; 8:183-92. [PMID: 26493413 PMCID: PMC4804030 DOI: 10.5539/gjhs.v8n3p183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/30/2015] [Accepted: 05/21/2015] [Indexed: 11/24/2022] Open
Abstract
Osteoporosis is a major public health priority in Iran and throughout the world. The prevention of osteoporosis has recently become the ultimate goal of many health professionals. Behavior change is one of the most powerful strategies to prevent osteoporosis. This study aimed to determine the predictive construct of physical preventive behavior of osteoporosis in women aged 30-50 in Khorramabad, west of Iran. This study included 269 women selected from all the health centers of Khorramabad city according to the inclusion criteria of the study and through random cluster and systematic sampling. The data gathering tools were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and physical activity. Data were analyzed using descriptive and inferential statistics. The mean of the subjects’ age was 38.72±7.003, and the mean of light weekly physical activity was 38.83±56.400. The results showed that the construct of self-efficacy had the highest predictive power of the preventive behavior. The results also showed that self-efficacy among the constructs of the Trans-theoretical Model was the only predictive construct for osteoporosis prevention behavior. Therefore, the findings of this study can serve as a base for educational interventions in behavioral changes to prevent of osteoporosis by health authorities.
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Affiliation(s)
- Farideh Malekshahi
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University.
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14
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Gilasi HR, Soori H, Yazdani S, Taheri Tenjani P. Fall-Related Injuries in Community-Dwelling Older Adults in Qom Province, Iran, 2010-2012. ARCHIVES OF TRAUMA RESEARCH 2015; 4:e22925. [PMID: 26064869 PMCID: PMC4460262 DOI: 10.5812/atr.22925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/14/2014] [Accepted: 12/10/2014] [Indexed: 11/16/2022]
Abstract
Background: Falls and related injuries are common health problems in the elderly. Fractures, brain and internal organ injuries and death are the common consequences of the falls, which result in dependence, decreased self-efficacy, fear of falling, depression, restricted daily activities, hospitalization and admission to the nursing home and impose costs on the individual and the society. Objectives: The purpose of this study was to determine the types of fall-related injuries and the related risk factors in the elderly population of Qom province, Iran. Patients and Methods: This retrospective study was performed on 424 elderly people (65 years and over) referred to Shahid Beheshti Hospital, Qom, Iran, due to falls between 2010 and 2012. The ICD-10 codes of external causes of injury from w00 to w19 related to falls were selected from the health information system of the hospital and demographic variables of the patients and external causes of falls were extracted after accessing the files of the patients. Data were analyzed using SPSS version 18 (SPSS Inc., USA). The duration of hospital stay and its relationship with underlying variables were investigated using t test and ANOVA. The level of significance was considered P < 0.05. Results: Among 424 elderly people, 180 cases (42.45%) were male and the mean age of the patients was 78.65 ± 7.70 years. Fall on the same level from slipping, tripping, and stumbling was the most common external cause with 291 victims (68.60%), and hip fracture in 121 patients (29.00%), intertrochanteric fracture in 112 patients (26.90%), and traumatic brain injury in 51 patients (12.20%) were the most common causes of hospital stay. The mean hospital stay was 7.33 ± 3.63 days. Conclusions: Lower limb fracture and traumatic brain injury were the most common causes of hospitalization, which resulted in the longest hospital stay and highest hospitalization costs in the elderly.
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Affiliation(s)
- Hamid Reza Gilasi
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Hamid Soori, Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9133611401, Fax: +98-2122439980, E-mail:
| | - Shahram Yazdani
- Faculty of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Parisa Taheri Tenjani
- Department of Internal Medicine, Ayatollah Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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15
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Kalula SZ, Ferreira M, Swingler GH, Badri M. Ethnic differences in rates and causes of falls in an urban community-dwelling older population in South Africa. J Am Geriatr Soc 2015; 63:403-4. [PMID: 25688622 DOI: 10.1111/jgs.13277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Sebastiana Z Kalula
- Division of Geriatric Medicine, Albertina and Walter Sisulu Institute of Ageing in Africa, University of Cape Town, Cape Town, South Africa
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16
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Cassim B, Lipschitz S, Paruk F, Tipping B. Recommendations for the acute and long-term medical management of low-trauma hip fractures. JOURNAL OF ENDOCRINOLOGY METABOLISM AND DIABETES OF SOUTH AFRICA 2014. [DOI: 10.1080/22201009.2013.10872302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- B Cassim
- Department of Geriatrics, School of Clinical Medicine, University of KwaZulu-Natal
- Member of National Osteoporosis Foundation of South Africa Council and Executive Committee of the South African Geriatrics Society
| | - S Lipschitz
- Private Practice, Member of the National Osteoporosis Foundation of South Africa Council and the South African Geriatrics Society
| | - F Paruk
- Division of Medicine, School of Clinical Medicine, University of KwaZulu-Natal
| | - B Tipping
- Division of Geriatric Medicine, Department of Medicine, University of the Witwatersrand Donald Gordon Medical Centre and Helen Joseph Hospital, Johannesburg; President of the South African Geriatrics Society
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17
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Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB. The incidence rate of hip fracture in Shiraz, Iran during 2008-2010. Arch Osteoporos 2014; 9:165. [PMID: 24424876 DOI: 10.1007/s11657-013-0165-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/25/2013] [Indexed: 02/05/2023]
Abstract
UNLABELLED This study aimed to estimate the incidence rate of hip fracture during 2008-2010 in Shiraz, Iran. Overall, the standardized age-related incidence were 329.6/100,000 in men and 1,589.7/100,000 in women. The incidence rate in females was remarkably higher than the previous studies in Iran. PURPOSE This study aims to determine the incidence rate of hip fracture and its possible changes during 2008-2010 in Shiraz, Iran. MATERIALS AND METHODS This study reviewed and abstracted the hospital records, demographic, and clinical data of 1,923 patients aged 50 years or older with first time hip fracture admitted to private and public hospitals of Shiraz, Iran during 2008-2010 The age-adjusted incidence rate of hip fracture was determined along with association between gender, age, site of fracture, and socioeconomic status (SES) with the incidence rate. RESULTS The mean age of subjects was 74.7 years (±10.6 years). Age-adjusted incidence rates for hip fracture, standardized to the 2000 US white male and female populations were 329.57 and 1,589.71 per 10(5), respectively, while totally it was 461.1 per 10(5). The incidence rate of hip fracture in females was higher than that of males in their 60s (1,229.2 versus 793.3), 70s (4,130.3 versus 2,835.3), and early 80s (4,506.8 versus 3,820.5) per 100,000. The hip fracture incidence in high SES area (157.1 per 100,000) followed by low SES regions (152.5 per 100,000) were higher compared to middle SES area (38.1 per 100,000) and towns around Shiraz (27.7 per 100,000) with fracture of the neck of femur being the most frequent affliction (391 per 100,000). CONCLUSIONS The rate of hip fracture is increasing in the area under study particularly in women and to a greater extent in those aged 60 years or older. Therefore, it is necessary to pay special attention to primary and secondary prevention of hip fracture.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Sweileh WM, Al-Jabi SW, Zyoud SH, Sawalha AF, Ghanim MA. Osteoporosis is a neglected health priority in Arab World: a comparative bibliometric analysis. SPRINGERPLUS 2014; 3:427. [PMID: 25152852 PMCID: PMC4141069 DOI: 10.1186/2193-1801-3-427] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 08/06/2014] [Indexed: 02/07/2023]
Abstract
Osteoporosis is an important health problem with serious consequences. Evaluation of osteoporosis scientific output from Arab countries has not been explored and there are few internationally published reports on research activity about osteoporosis. The main objectives of this study were to analyze the research output originating from Arab countries and 3 Middle Eastern non-Arab countries, particularly Israel, Turkey and Iran in the field of osteoporosis. Original scientific articles or reviews published from the 21 Arab countries, Israel, Turkey and Iran about "osteoporosis" were screened using the ISI Web of Science database. The time frame for the result was up to year 2012. The total number of original and review research articles published globally about osteoporosis was 43,571. The leading country in osteoporosis research was United States of America (14,734; 33.82%). Worldwide, Turkey ranked 16th while Israel and Iran ranked 24th and 31st respectively. Among Arab countries, Egypt and Kingdom of Saudi Arabia came on positions 41 and 45 respectively. A total of 426 documents about "osteoporosis" were published from Arab countries which represents 0.98% of the global research output. Research about osteoporosis from Arab countries was very low until 2002 and then increased steadily. The total number of citations for osteoporosis documents from the Arab world was 5551 with an average citation of 13.03 per document and an h- index of 35. Thirty (7.04%) documents published from Arab countries about osteoporosis were published in Saudi Medical Journal. Egypt, with a total publication of 117 (27.47%) ranked first among the Arab countries in research about osteoporosis while American University in Beirut was the most productive institution with a total of 47 (11.03%) documents. Compared with other non-Arab countries in the Middle East, the research productivity from the Arab countries was lesser than that from Turkey and Israel but higher than that from Iran. The present data showed low research productivity in osteoporosis field in Arab countries. Research output can be improved by investing in more international and national collaborative research projects in the field of osteoporosis.
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Affiliation(s)
- Waleed M Sweileh
- Department of Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ansam F Sawalha
- Department of Pharmacology/Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mustafa A Ghanim
- Department of Biochemistry and Genetics, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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19
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Dhanwal DK, Siwach R, Dixit V, Mithal A, Jameson K, Cooper C. Incidence of hip fracture in Rohtak district, North India. Arch Osteoporos 2013; 8:135. [PMID: 23620225 PMCID: PMC3653238 DOI: 10.1007/s11657-013-0135-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/25/2013] [Indexed: 02/03/2023]
Abstract
UNLABELLED Hip fracture incidence is not known in India. This retrospective study was conducted to evaluate hip fracture incidence rates in Rohtak, a single district of North India. A total of 304 patients from this district with hip fracture were hospitalized during the calendar year 2009. The crude hip fracture rates were found to be 159 and 105 per 100,000, respectively, in women and men above the age of 50 years. Hip fracture is a significant health problem in North India. PURPOSE This aims to study hip fracture incidence in Rohtak district of North India. METHODS The study was conducted in Rohtak district, Haryana state, India located 80 km north of New Delhi. All patients having hip fracture admitted in Pandit B.D. Sharma Postgraduate Institute or one of the four orthopaedic centres located in Rohtak in year 2009 were included. Total population of Rohtak for the year 2009 was used to calculate age-specific hip fracture incidence. RESULTS A total of 541 patients with hip fracture were hospitalized in Rohtak district in year 2009. Out of these, 304 were from Rohtak district. Hip fracture crude incidence above the age of 50 years was 129 per 100,000. The corresponding figures were 105 and 159 per 100,000 among men and women, respectively. Hip fracture incidence was similar in both sexes till age of 55 years. From age of 55 onwards, the rates were significantly higher in women. CONCLUSIONS This is the first hip fracture incidence study from India. Hip fracture incidence rates in Rohtak district of India are intermediate between those in the industrialised world and Africa and similar to some of Asian countries such as China, Iran and South Korea. This study will help in formulating strategies for prevention of hip fracture in India.
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Affiliation(s)
- D. K. Dhanwal
- Medicine, Maulana Azad Medical College, New Delhi, India
| | - R. Siwach
- Orthopaedics, Pt B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - V. Dixit
- Medicine, Maulana Azad Medical College, New Delhi, India
| | - A. Mithal
- Endocrinology, Medanta Medicity, Gurgaon, Haryana, India
| | - K. Jameson
- Lifecourse Epidemiology Unit, Medical Research Centre, Southampton, United Kingdom
| | - C. Cooper
- Lifecourse Epidemiology Unit, Medical Research Centre, Southampton, United Kingdom
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20
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Saeb M, Beyranvand M, Basiri Z, Haghparast-Bidgoli H. The hospital resource utilization associated with osteoporotic hip fractures in Kermanshah, Iran. J Inj Violence Res 2013; 6:16-20. [PMID: 23793366 PMCID: PMC3865451 DOI: 10.5249/jivr.v6i1.492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/22/2013] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Hip fracture is the most serious complication of osteoporosis and imposes a significant financial burden on countries' economy. This study aimed to assess the hospitalization costs and length of stay associated with osteoporosis hip fractures and identify the major cost components in a referral hospital in Kermanshah city, Iran. METHODS In a prospective study, from May 21 2007 to May 21 2008, all patients with osteoporotic hip fracture admitted to a referral hospital for operation were recruited as the study sample. For each patient, information such as age, gender, length of stay (LOS) in hospital and intensive care unit (ICU), medical and diagnostic procedures and cost of surgery and implant were collected both through interview with the patient or a family member and the patients' hospital records. RESULTS A total of 103 patients (56 men and 47 women) were studied. The average hospital length of stay (LOS) for the patients was 9.7 days, ranging from 5 to 38 days. The average total hospitalization costs was 7,208,588 IRR (US$774). The main components of the costs were ward stay (16.3%), operative (54.6%), implant (26%) and medical and diagnostic procedures (3.1%). CONCLUSIONS The results of this study demonstrate that the hospital resource burden associated with osteoporotic hip fractures in Iran is substantial and expected to rise with the projected increase of life expectancy and the number of elderly in Iran. Estimating the economic burden of osteoporotic hip fractures provide information that can be of importance in the planning and design of preventive strategies.
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Affiliation(s)
| | - Mandana Beyranvand
- Department of Internal Medicine, School of Medicine, AJA University of Medical Science, Tehran, Iran.
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21
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Maalouf G, Bachour F, Hlais S, Maalouf NM, Yazbeck P, Yaghi Y, Yaghi K, El Hage R, Issa M. Epidemiology of hip fractures in Lebanon: a nationwide survey. Orthop Traumatol Surg Res 2013; 99:675-80. [PMID: 24007698 DOI: 10.1016/j.otsr.2013.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/26/2013] [Accepted: 04/02/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Hip fractures are a reliable indicator of osteoporosis. Despite their importance, few studies have assessed their epidemiology in Lebanon and the Middle East. HYPOTHESES Hip fracture incidence rates in Lebanon approximate those of Northern countries, and show the same characteristics, particularly the exponential increase with age, higher incidence in women, and a recent trend of rate leveling in women but not in men. MATERIALS AND METHODS A national database of hip fracture cases admitted to hospitals in Lebanon in 2007 was created. Crude and age-adjusted incidence rates were calculated at 5-year intervals for individuals over age 50. These rates were also standardized to the 2000 United States population, and compared to those of other countries. Projected incidence rates in Lebanon in 2020 and 2050 were also calculated. RESULTS A total of 1199 patients were included in the study. The crude annual incidence rate in individuals over 50 was 147 per 100,000 individuals, 132 per 100,000 males and 160 per 100,000 females, with a female-to-male ratio of 1.2. The age-standardized annual incidence rates (per 100,000) were 180 in males and 256 in females. Assuming unchanged healthcare parameters, the projected crude incidence rates for people over 50 are expected to reach 174 and 284 per 100,000 in 2020 and 2050 respectively. CONCLUSIONS Lebanese hip fracture rates are lower than Northern countries, but show many similar characteristics such as an exponential increase with age, a higher incidence in women, and clues of a leveling of rates in women but not in men. Numbers are expected to increase substantially in the coming decades. LEVEL OF EVIDENCE Level IV. Epidemiological study.
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Affiliation(s)
- G Maalouf
- Musculoskeletal Department, Bellevue University Medical Center, Faculty of Medicine, Saint-Joseph University, Mansourieh, Lebanon
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22
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Yeganeh A, Shah-Hoseini G, Ghavami Y. Effect of BMI on Mobility of Patients with Proximal Femoral Fracture. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:873-4. [PMID: 24616803 PMCID: PMC3929828 DOI: 10.5812/ircmj.2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 03/07/2012] [Accepted: 07/26/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Ali Yeganeh
- Orthopedic Department, RasoolAkram Hospital, Tehran, IR Iran
- Corresponding author: Ali Yeganeh, Orthopedic Department, Rasool-Akram Hospital, Tehran, IR Iran. Tel.:+98-9123216055, Fax: +98-2166554785, E-mail:
| | | | - Yaser Ghavami
- General Practitioners, Tehran University of Medical Sciences, Tehran, IR Iran
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Litwic A, Edwards M, Cooper C, Dennison E. Geographic differences in fractures among women. WOMEN'S HEALTH (LONDON, ENGLAND) 2012; 8:673-84. [PMID: 23181532 PMCID: PMC3736314 DOI: 10.2217/whe.12.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Osteoporotic fracture is associated with considerable morbidity and mortality in women throughout the world. However, significant variation in hip fracture rates among women from different nations has been observed and is likely to represent a combination of real and apparent differences due to ascertainment bias. Higher rates are observed in Caucasian women, with lowest rates observed in black women and intermediate rates among Asian women. These differences are likely to represent a combination of genetic and environmental differences; for example, among European women, the highest fracture rates are observed in Scandinavian women where vitamin D insufficiency is common. In all groups, an increase in absolute fracture numbers is anticipated due to demographic changes.
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Affiliation(s)
- Anna Litwic
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - Mark Edwards
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
- University of Oxford, UK
| | - Elaine Dennison
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
- Victoria University, Wellington, New Zealand
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24
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Støen RO, Nordsletten L, Meyer HE, Frihagen JF, Falch JA, Lofthus CM. Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway. Osteoporos Int 2012; 23:2527-34. [PMID: 22246602 DOI: 10.1007/s00198-011-1888-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 12/14/2011] [Indexed: 11/25/2022]
Abstract
UNLABELLED This study reports a significant decrease in age-adjusted incidence rates of hip fracture for women in Oslo, Norway, even compared with data from 1978/1979. Use of bisphosphonate may explain up to one third of the decline in the incidence. INTRODUCTION The aims of the present study were to report the current incidence of hip fractures in Oslo and to estimate the influence of bisphosphonates on the current incidence. METHODS Using the electronic diagnosis registers and lists from the operating theaters of the hospitals of Oslo, all patients with ICD-10 codes S72.0 and S72.1 (hip fracture) in 2007 were identified. Medical records of all identified patients were reviewed to verify the diagnosis. Age- and gender-specific annual incidence rates were calculated using the population of Oslo on January 1, 2007 as the population at risk. Data on the use of bisphosphonates were obtained from official registers. RESULTS A total number of 1,005 hip fractures, 712 (71%) in women, were included. The age-adjusted fracture rates per 10,000 for the age group >50 years were 82.0 for women and 39.1 for men in 2007, compared with 110.8 and 41.4 in 1996/1997, 116.5 and 42.9 in 1988/1989, and 97.5 and 34.5 in 1978/1979, respectively. It was estimated that the use of bisphosphonates may explain up to 13% of the decline in incidence in women aged 60-69 years and up to 34% in women aged 70-79 years. CONCLUSIONS The incidence of hip fractures in women in Oslo has decreased significantly during the last decade and is now at a lower level than in 1978/1979. This reduction was not evident in men. The incidence of hip fractures in Oslo is, however, still the highest in the world.
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Affiliation(s)
- R O Støen
- Department of Orthopaedics, Oslo University Hospital, Ullevål, 0424 Oslo, Norway.
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25
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Valizadeh M, Mazloomzadeh S, Golmohammadi S, Larijani B. Mortality after low trauma hip fracture: a prospective cohort study. BMC Musculoskelet Disord 2012; 13:143. [PMID: 22883372 PMCID: PMC3512527 DOI: 10.1186/1471-2474-13-143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Accepted: 07/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various risk of mortality due to hip fracture has been reported by different studies. There is scarce controlled study on hip fracture mortality from developing countries and no data from Middle East region. The objective of this study is to determine mortality and its risk factors one year after low trauma hip fracture. METHODS One hundred and two patients after hip fracture not caused by high impact injuries or local bone diseases followed up prospectively for one year. Control group consisted of sex and age matched patients admitted to ophthalmology ward for eye surgery. Data about comorbidity obtained from both groups at baseline. Functional state and health-related quality of life for the participants were measured using RDRS-2 and SF-36 questionnaires, respectively. RESULTS The overall survival was 83% in cases and 92% in controls (log rank test 3.62, df = 1, P = 0.057). Early mortality within the first 6 months of observation was significantly higher in patients than controls (13 in patients vs. 2 in controls) (log rank test 8.84, df = 1, P = 0.003). The risk of mortality in the first year after fracture was significantly and independently associated with age and baseline RDRS score. By the end of follow-up, in the patient group, 55.4% of survivors were able to walk without any assistance and 10.8% were not able to walk. CONCLUSIONS The risk of mortality within the first 6 months of observation was significantly and independently associated with low trauma hip fracture. However, age and baseline RDRS score were independent predictors of mortality in the first year following hip fracture.
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Affiliation(s)
- Majid Valizadeh
- Metabolic disease research center, Zanjan University of Medical Sciences, Iran
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Kalula SZ, Scott V, Dowd A, Brodrick K. Falls and fall prevention programmes in developing countries: environmental scan for the adaptation of the Canadian Falls prevention curriculum for developing countries. JOURNAL OF SAFETY RESEARCH 2011; 42:461-472. [PMID: 22152264 DOI: 10.1016/j.jsr.2010.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 10/09/2010] [Accepted: 12/07/2010] [Indexed: 05/31/2023]
Abstract
PROBLEM Falls in older persons in developing countries are poorly understood, and falls prevention and health promotion programmes for this population are largely lacking. METHODS A systematic review was carried out of relevant literature on falls and prevention programmes, and falls prevention education, and a scan undertaken of health promotion programmes for older persons in a representative country - South Africa. RESULTS Studies on the risk and prevalence of falls are largely retrospective and hospital-based, with varied methodology, including study period, sampling method and sample size. Falls prevalence is based largely on self-reports in studies on general trauma in all age groups. Falls incidence varies from 10.1% to 54%. No reports could be traced on sustained falls prevention or health promotion programmes. CONCLUSION Scant research has been conducted and little preventive education offered on falls in older persons. Adaptation of the Canadian Falls Prevention Curriculum for developing countries will help to fill gaps in knowledge and practice. IMPACT ON INDUSTRY With rapid increase in the populations of older persons in developing countries, research on age related disorders such as falls is required to guide policy and management of falls.
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Affiliation(s)
- Sebastiana Zimba Kalula
- The Albertina and Walter Sisulu Institute of Ageing in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
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Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B. Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int 2011; 22:2575-86. [PMID: 21484361 DOI: 10.1007/s00198-011-1596-z] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 02/14/2011] [Indexed: 12/18/2022]
Abstract
UNLABELLED A comprehensive review of literature was conducted to investigate variation in hip fracture incident rates around the world. The original crude incidence rates were standardized for age and sex for comparability. After standardization, the highest rates of hip fracture were found in Scandinavia and the lowest rates in Africa. INTRODUCTION This study was conducted to investigate the geographic trends of the incidence of osteoporotic hip fractures through a comprehensive review of literature. METHODS Studies were identified for inclusion in the review by searching the MEDLINE database via PubMed and applying strict inclusion and exclusion criteria. Age-specific incidence rates were extracted from the articles, and in order to provide a common platform for analysis, we used directly age-standardized and age-sex-standardized rates (using the 2005 United Nations estimates of the world population as standard) to complete the analysis. RESULTS Forty-six full text articles spanning 33 countries/regions were included in the review. For ease of comparison, the results were analyzed by geographic regions: North America, Latin America, Scandinavia, Europe (excluding Scandinavia), Africa, Asia, and Australia. The highest hip fracture rates were found in Scandinavia and the lowest in Africa. We found comparable rates from countries in North America, Australia, and Europe outside of Scandinavia. The diverse makeup of the Asian continent also resulted in quite variable hip fracture rates: ranging from relatively high rates in Iran to low rates, comparable to those from Africa, in mainland China. CONCLUSIONS Given the aging of populations globally, and in the industrialized countries specifically, hip fractures will become a progressively larger public health burden. The geographic trends observed in hip fracture incidence rates can provide important clues to etiology and prevention.
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Affiliation(s)
- S Y Cheng
- Department of Statistics, University of British Columbia, Vancouver, Canada
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Baddoura R, Hoteit M, El-Hajj Fuleihan G. Osteoporotic fractures, DXA, and fracture risk assessment: meeting future challenges in the Eastern Mediterranean Region. J Clin Densitom 2011; 14:384-94. [PMID: 21839659 DOI: 10.1016/j.jocd.2011.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 03/24/2011] [Accepted: 03/28/2011] [Indexed: 10/17/2022]
Abstract
The purpose was to report on the burden of osteoporotic fractures in the Eastern Mediterranean Region (EMR) and the use of bone mineral density (BMD) dual-energy X-ray absorptiometry (DXA) databases for osteoporosis diagnosis. PubMed electronic database was reviewed using the following MeSH terms: "Hip fractures," "Fractures, Compression," "Radius Fractures," "Osteoporosis," "Bone density," and "Middle East" up to July 2009. Incidence of hip fractures varied across the EMR between 100 and 295 per 100,000 person-years in women and 71 and 200 per 100,000 person-years in men. No data were found on other nonvertebral osteoporotic fractures. Prevalence of radiographic vertebral fractures older than 65 yr ranged between 15% and 25% in women and 7.3% and 18% in men. By 2020, the number of hip fractures older than 50 yr would increase by 20%. DXA manufacturer's reference curves for the spine were higher than population-specific ones. At the hip, National Health and Nutrition Examination Survey (NHANES) and population-based curves were comparable. Estimates of the relative risk of vertebral fracture per SD decrease in BMD using NHANES and local data set were similar, that is, 1.61 (1.17-2.23) and 1.49 (1.14-1.95), respectively. The EMR is similar to southern Europe regarding incidence rates of hip fracture, suggesting the health burden to be significant. Using DXA at the hip, population-specific reference databases did not perform better than NHANES on which the FRAX model has been developed highlighting the need for reviewing fracture risk assessment strategies in the EMR.
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Affiliation(s)
- R Baddoura
- Division of Rheumatology, Hotel Dieu de France Hospital, Beirut, Lebanon.
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Sibai AM, Nasser W, Ammar W, Khalife MJ, Harb H, Fuleihan GEH. Hip fracture incidence in Lebanon: a national registry-based study with reference to standardized rates worldwide. Osteoporos Int 2011; 22:2499-506. [PMID: 21069293 DOI: 10.1007/s00198-010-1468-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 10/13/2010] [Indexed: 11/24/2022]
Abstract
UNLABELLED Crude incidence rates for hip fractures in individuals aged 50 and above in Lebanon were determined using data from the national hip fracture registry. For the years 2006-2008, crude rates varied between 164 and 188/100,000 for females and between 88 and 106 per 100,000 for males. Using the US 2000 white population as a reference, the calculated age-standardized rates were closest to rates derived for southern Europe. INTRODUCTION Owing to the demographic explosion, it is projected that the rates of hip fractures would increase the most in the Middle East and Asia. Few are the population-based studies investigating the incidence of hip fractures in the region. METHODS Using the Ministry of Health registry data, this population-based study evaluated the incidence of hip fractures in individuals aged 50 and above in Lebanon for the years 2006, 2007, and 2008. RESULTS Hip fracture crude incidence rates varied across the years between 164 and 188 per 100,000 for females and between 88 and 106 per 100,000 for males, with a female/male ratio of 1.6-2.1. The overall mean age (SD) for hip fractures was 75.9 (9.2), 76.8 (9.0), and 77.0 (9.9) years in females in 2006, 2007, and 2008, respectively, and 74.4 (11.6), 76.3 (10.3), and 74.0 (12.1) years in males, respectively. Using the US 2000 white population as a reference, the age-standardized rates were 370.4, 335.1, and 329.0 for females and 109.7, 134.1, and 128.7 for males, for the years 2006, 2007, and 2008, respectively. CONCLUSIONS The hip fracture age-standardized incidence rates in the Lebanese subjects receiving Ministry of Health coverage were lower than those found in northern Europe and the US and closest to rates derived for southern Europe.
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Affiliation(s)
- A M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut (AUB), PO BOX: 11-0236, Riad El Solh, 1107 2020, Beirut, Lebanon.
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Arakaki H, Owan I, Kudoh H, Horizono H, Arakaki K, Ikema Y, Shinjo H, Hayashi K, Kanaya F. Epidemiology of hip fractures in Okinawa, Japan. J Bone Miner Metab 2011; 29:309-14. [PMID: 20814705 DOI: 10.1007/s00774-010-0218-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 07/19/2010] [Indexed: 11/27/2022]
Abstract
This study investigated the current incidence of hip fractures in Okinawa prefecture and compared the data with those obtained in our previous study, which was conducted using similar methods in 1987/1988. All patients, aged 50 years or older and residing in Okinawa, admitted to Okinawa hospitals in 2004 for a fresh hip fracture were identified from hospital registries. Details were obtained from the medical records and radiographs of all patients and classified according to fracture type (cervical or trochanteric), age, sex, and fracture location. Subtrochanteric fractures and pathological fractures were excluded. A total of 1,349 patients (242 men and 1,107 women) were admitted for a fresh hip fracture in 2004. Their average age was 76.9 years for men and 82.4 years for women. There were 671 cervical fractures, 654 trochanteric fractures, and 24 unclassified proximal femoral fractures. Comparing the data from 1987/1988 to those from 2004, the total number of hip fractures increased by 188%, from 469 to 1,349. The age-adjusted incidence rates per 100,000, standardized to the 2000 US population, were 75.7 and 296.1 in 1987/1988 and 123.6 and 420 in 2004 for men and women, respectively. The incidence rates in all age groups (at 5-year intervals) were higher in 2004 than in 1987/1988, indicating that people 50 years of age or older became more susceptible to hip fractures. Accordingly, the accretion of the hip fracture incidence rate was greater than that which could be explained purely by changes in population size and structure.
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Affiliation(s)
- Harumi Arakaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Abstract
Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates) and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.
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Affiliation(s)
- Dinesh K Dhanwal
- Maulana Azad Medical College, New Delhi, India,Address for correspondence: Prof. Dinesh Dhanwal, Department of Medicine (Endocrinology), Maulana Azad Medical College, New Delhi, India 110002. E-mail:
| | | | | | - Cyrus Cooper
- MRC Epidemiology Resource Center, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK,Botnar Research Center, Institute of Musculoskeletal Sciences, University of Oxford OX3 7LD, UK
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Lai SW, Liao KF, Liao CC, Muo CH, Liu CS, Sung FC. Polypharmacy correlates with increased risk for hip fracture in the elderly: a population-based study. Medicine (Baltimore) 2010; 89:295-299. [PMID: 20827106 DOI: 10.1097/md.0b013e3181f15efc] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Few studies have addressed the association between polypharmacy and hip fracture using population data. We conducted a population-based case-control study to investigate whether polypharmacy increases the risk for hip fracture in the elderly. We used insurance claims data from the Taiwan Bureau of National Health Insurance, a universal insurance program with a coverage rate of more than 98% of the population in Taiwan. We identified 2328 elderly patients with newly diagnosed hip fracture during the period 2005-2007. We randomly selected 9312 individuals without hip fracture to serve as the control group. Patient characteristics, drugs prescribed by physicians, and all types of hip fracture were ascertained. The odds ratio (OR) of hip fracture in association with the number of medications used per day in previous years was assessed.We found that patients were older than controls, predominantly female, and more likely to use 5 or more drugs (22.2% vs. 9.3%, p < 0.0001). The OR of hip fracture increased with the number of medications used per day and with age. Multivariate logistic regression analysis revealed that the overall OR for patients using 10 or more drugs was 8.42 (95% confidence interval [CI], 4.73-15.0) compared with patients who used 0-1 drug per day. However, age-specific analysis revealed that the risk for hip fracture was 23 times greater for patients aged > or = 85 years who used 10 or more drugs than for those aged 65-74 years who used 0-1 drug after controlling for covariates (OR, 23.0; 95% CI, 3.77-140).We conclude that the risk of hip fracture in older people increases with the number of medications used, especially in women. Age interacts with the daily medications for the risk of hip fracture.
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Affiliation(s)
- Shih-Wei Lai
- From Department of Family Medicine (SWL, CSL), China Medical University Hospital, Taichung City; Department of Internal Medicine (KFL), Taichung Tzu Chi General Hospital, Taichung County; and China Medical University and Hospital Department of Public Health and Management Office for Health Data (CCL, CHM, FCS), Taichung City, Taiwan
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Dhanwal DK, Cooper C, Dennison EM. Geographic variation in osteoporotic hip fracture incidence: the growing importance of asian influences in coming decades. J Osteoporos 2010; 2010:757102. [PMID: 20981334 PMCID: PMC2957223 DOI: 10.4061/2010/757102] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 06/08/2010] [Accepted: 06/29/2010] [Indexed: 11/20/2022] Open
Abstract
Studies over the last few decades have demonstrated geographic variation in the incidence of hip fracture across continents and among different parts of the same region. This paper studies the epidemiology of hip fracture worldwide, with special emphasis on the geographic variation among Asian countries. Using the Pubmed database, keywords that were employed included hip fracture, incidence rate, geographic variation, osteoporosis, and epidemiology. Articles were chosen based on the basis of (1) focus: studies that were said to specifically focus on geographic variation in hip fracture from different continents with a focus on Asia; (2) language: studies that were in English; (3) methods: studies that used statistical tests to examine hip fracture incidence rates. The highest hip fracture rates are seen in Scandinavian countries and the US and the lowest in African countries. Fracture rates are intermediate in Asian populations. Among different ethnic populations, the highest fracture rates are seen in Caucasians and the lowest in blacks. There is also a north-south gradient, particularly in Europe, where more hip fractures occur in North Europe compared to the South.
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Affiliation(s)
- D. K. Dhanwal
- MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - C. Cooper
- MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK,Botnar Research Centre, Institute of Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - E. M. Dennison
- MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK,*E. M. Dennison:
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Tan S, Ji L, Tsai J, Eng J, Ko HJ, Yau A, Edwards G, Bunta A, Edwards BJ. Greater osteoporosis educational outreach is desirable among Chinese immigrants in Chinatown, Chicago. Osteoporos Int 2009; 20:1517-22. [PMID: 19148565 DOI: 10.1007/s00198-008-0828-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Accepted: 11/17/2008] [Indexed: 10/21/2022]
Abstract
UNLABELLED Osteoporosis beliefs were assessed in immigrant Chinese women in Chinatown, Chicago. Results from a survey utilizing the Osteoporosis Health Belief Scale showed that women expressed concern about osteoporosis but lacked both knowledge of preventive care and health motivation. INTRODUCTION The objective of this study was to assess osteoporosis beliefs in immigrant Chinese women in Chinatown, Chicago. METHODS In a community-based health fair, osteoporosis knowledge and self-efficacy among postmenopausal Chinese immigrants were assessed using the translated Osteoporosis Health Belief Scale. Bone mineral density (BMD) was assessed with calcaneal ultrasound. RESULTS The study population included 94 women with mean age of 51 +/- 9 years, mean length of residence in the United States of 9 +/- 7 years, and 73% (n = 76) of whom were recent immigrants. Women expressed concern about the seriousness of osteoporosis and their relative susceptibility to osteoporosis. In particular, women with a prior fracture reported higher seriousness to osteoporosis. Nonetheless, women exhibited low health motivation and low awareness of the benefits of calcium and exercise. Bone densitometry results corresponded to a T score of -1.2 +/- 1.5. Multiple regression analysis revealed that a younger age and longer length of residence in the USA were associated with higher BMD. CONCLUSION Chinese immigrant women in Chicago exhibit concern regarding osteoporosis, but are unaware of the benefits of calcium and exercise, and exhibit low health motivation. Chinese women in Chinatown lack necessary knowledge about osteoporosis to develop adequate self-efficacy. Public health initiatives should be undertaken among recent immigrant Chinese women.
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Affiliation(s)
- S Tan
- Bone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, 645 North Michigan Avenue, Suite 630, Chicago, IL 60611, USA
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Jamal Sepah Y, Umer M, Khan A, Ullah Khan Niazi A. Functional outcome, mortality and in-hospital complications of operative treatment in elderly patients with hip fractures in the developing world. INTERNATIONAL ORTHOPAEDICS 2009; 34:431-5. [PMID: 19471932 DOI: 10.1007/s00264-009-0803-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 04/11/2009] [Accepted: 04/27/2009] [Indexed: 11/30/2022]
Abstract
Hip fracture has been increasing in frequency for several decades, and 70-90% of patients who sustain a hip fracture survive for at least one year. Many of these survivors fail to regain their prefracture functional status. No work in this regard has been done in the developing world. Elderly patients with acute intertrochanteric fracture and fracture of the femoral neck were followed up prospectively for 12 months after surgery to record the mortality, morbidity, functional status and complications. Three hundred and forty-five patients (61% female) were assessed at six and 12 months after surgery, which included 62.9% intertrochanteric fractures and 37% femoral neck fractures. The mechanism of injury was from a fall in 67% of the cases. Nineteen patients died within six months after surgery while another eight died during the next six months. Obesity, male gender, multiple comorbidities and below normal ambulation status before fracture were identified as major determinants of bad functional outcome.
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Beyranvand M, Mohammadi G. Incidence of hip fracture in Kermanshah, Iran. Arch Osteoporos 2009; 4:67-70. [PMID: 20234853 PMCID: PMC2836741 DOI: 10.1007/s11657-009-0030-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2009] [Accepted: 09/01/2009] [Indexed: 02/03/2023]
Abstract
SUMMARY: The aim of this study was to estimate the incidence of hip fracture in Kermanshah, Iran. 161 cases (88 men and 73 women) were recorded. The annual age-standardized incidence rates were 181.1/100,000 in men and 214.6/100,000 in women. Incidence rate of hip fracture was less than in Western countries. INTRODUCTION: Hip fracture is the most serious complication of osteoporosis, the most common metabolic bone disease worldwide. The incidence of hip fracture in the elderly patients varies in different areas. The aim of this study was to estimate the incidence rate of hip fracture in Kermanshah, Iran. MATERIALS AND METHODS: All cases of hip fracture patients who aged 50 years or more admitted in six referral orthopedic hospitals in Kermanshah from May 21, 2007 to May 21, 2008 were studied. The age- and sex-specific incidence rates of hip fracture per 100,000 persons were calculated using the population data from the last national census in Iran, 2007. RESULTS: A total of 161 cases of hip fracture (88 men and 73 women) were recorded. The annual age-standardized incidence rates were 181.1/100,000 in men and 214.6/100,000 in women. The female to male ratio of hip fracture incidence was 1.18. CONCLUSION: We found a relatively low incidence of hip fracture in Iran than in Western countries, which is mostly due to the lower rate in women. This is probably related to the different lifestyle factors in different societies.
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Affiliation(s)
- Mandana Beyranvand
- AJA University of Medical Science, Etemadzade St. Fatemi Ave., Tehran, Iran
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Morales-Torres J. [Not Available]. REUMATOLOGIA CLINICA 2008; 4:169-171. [PMID: 21794526 DOI: 10.1016/s1699-258x(08)72460-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 03/10/2008] [Indexed: 05/31/2023]
Affiliation(s)
- Jorge Morales-Torres
- Cátedra de Reumatología. Facultad de Medicina de León. Universidad de Guanajuato. Clínica de Osteoporosis. Hospital Aranda de la Parra. León-Gto. México
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Ahmadi-Abhari S, Moayyeri A, Abolhassani F. Burden of hip fracture in Iran. Calcif Tissue Int 2007; 80:147-53. [PMID: 17340222 DOI: 10.1007/s00223-006-0242-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2006] [Accepted: 11/24/2006] [Indexed: 10/23/2022]
Abstract
To measure the burden caused by hip fracture in Iran and to compare it with other parts of the world, we applied the Global Burden of Disease (GBD) method created by the World Health Organization. The GBD method uses disability-adjusted life years (DALY), which is comprised of years of life lost (YLL) and years of life lived with disability (YLD). To calculate YLD, incidence of hip fracture was obtained from the Iranian Multicenter Study on Accidental Injuries, a large-scale nationwide prospective study. Disability weights were applied to the remaining duration of disease. To calculate YLL, remaining years of potential life at any age at death were calculated using the standard life table. A discount rate of 3% and age weighting were applied. Hip fracture generated 16,708 DALYs, comprising 8,812 (52.7%) YLL and 7,896 (47.3%) YLD. Iran accounted for 0.85% of the global burden of hip fracture and 12.4% of the burden of hip fracture in the Middle East. The female to male ratio in Iran (1.1) was lower than the global (2.2) and the Middle Eastern (1.4) ratios and higher than the ratios in China and India (1.0 and 0.9, respectively). In conclusion, hip fracture is not as much a cause of disease burden in Iran as in the developed regions of the world. We recommend utilization of the standardized GBD method to calculate burden of osteoporosis in different countries and to set local priorities according to these measures.
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Affiliation(s)
- S Ahmadi-Abhari
- Endocrinology and Metabolism Research Center, Shariati Hospital, Tehran University of Medical Sciences, Northern Kargar Avenue, Tehran, 14114, Iran
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Hou YL, Wu XP, Luo XH, Zhang H, Cao XZ, Jiang YB, Liao EY. Differences in age-related bone mass of proximal femur between Chinese women and different ethnic women in the United States. J Bone Miner Metab 2007; 25:243-52. [PMID: 17593495 DOI: 10.1007/s00774-007-0756-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Accepted: 01/24/2007] [Indexed: 11/26/2022]
Abstract
Substantial racial differences in bone mass and bone loss rate have been reported, but the extent of the difference between native Chinese women and women of different races in the United States is not clear. We used a DXA bone densitometer to measure bone mineral density (BMD), bone mineral content (BMC), bone area (BA), and volumetric BMD (vBMD) in different regions of the proximal femur in 3614 Chinese women aged 20 years and older. Regression models were chosen to best fit the changes of these parameters with increasing age. The values in their fitted curves were determined by the Cartesian coordinate numeration system. Subsequently, we compared these fitted curves to full-matched data of non-Hispanic black, non-Hispanic white, and Mexican American women reported by the third National Health and Nutrition Examination Survey (NHANES III). We found that all fitted curves of bone mass of non-Hispanic black women were significantly higher than those of Chinese, non-Hispanic white, and Mexican American women (P = 0.000). The BMD and BMC fitted curves in various regions of the hip for non-Hispanic blacks were 22%-28% and 26%-43% higher than those for Chinese women, 8.3%-13% and 7.9%-9.5% higher than those for non-Hispanic whites, and 8.8%-10% and 13%-19% higher than those for Mexican Americans, respectively. However, when the expression of difference was transformed from BMD to vBMD at the femoral neck, the difference between Chinese and non-Hispanic black women was reduced from 22% to 18% and that between Chinese and non-Hispanic white women from 7.4% to 0.8%, but the difference increased from 3.2% to 9.6% between non-Hispanic white and Mexican American women and from 13% to 17% between non-Hispanic white and non-Hispanic black women. By the age of 80 years, the accumulated bone loss rate in various regions of the proximal femur for Chinese, Mexican Americans, non-Hispanic whites, and non-Hispanic blacks were -38.9% +/- 1.8%, -34.4% +/- 3.1%, -27.8% +/- 5.9%, and -28.4% +/- 4.8%, respectively. In conclusion, bone mass in the proximal femur of native Chinese women is significantly lower, and the bone loss rate greater, than those of non-Asian women in the United States. At the femoral neck, the vBMD of Chinese women is similar to that of non-Hispanic white women.
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Affiliation(s)
- Yan-Li Hou
- Institute of Metabolism and Endocrinology, The Second Xiang-Ya Hospital, Central South University, 86 Renmin-Zhong Rd, Changsha, Hunan, 410011, PR China
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