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Two-thirds of American osteoporotic hip fractures seen in the extreme elderly

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A study presented at the European League Against Rheumatism Annual Congress called for more aggressive management of osteoporosis in the extreme elderly, as patients 80 years or older represent two-thirds of American osteoporotic hip fractures.

“We know that hip fracture in the extreme elderly is a serious problem due to the associated consequences of hospitalization, disability and mortality,” study author Amrita Sehgal stated in a European League Against Rheumatism release. “This data is cause for concern as the impact highlighted will only increase along with this population segment. The question now is how we manage the extreme elderly more effectively to limit the impact that osteoporotic fractures have going forward.”

Sehgal’s team examined Nationwide Inpatient Sample hospitalizations from 1993 to 2008, seeking out elderly (65 years to 79 years of age) and extreme elderly (older than 80 years) patients diagnosed with osteoporotic hip fractures. Major trauma, open fractures and femoral tumors were considered exclusion criteria.

According to the study abstract, the team identified 4.3 million osteoporotic hip fracture hospitalizations falling within those criteria, with 67.3% of the fractures and hospitalizations occurring in the extreme elderly.

The authors noted a decrease in hip fracture hospitalizations for the elderly, from 96,928 in 1993 to 80,987 in 2008, despite an increase in the elderly population from 25.1 million to 27.1 million during that time.

However, the authors noted, osteoporotic hip fractures in the extreme elderly increased from 172,209 to 180,428 in that 16-year period despite an overall decrease in hip fracture prevalence. This coincides with a 46% increase in the extreme elderly population, it was reported.

“While the [extreme elderly] comprised 41.3% of the elderly population in 2008, they accounted for over 69% of all osteoporotic hip fracture hospitalizations, up from 64% in 1993,” the authors wrote.

According to the abstract, given the projected exponential growth in the extreme elderly population, the data indicates a need for more aggressive measures toward recognition, prevention and therapy of osteoporosis.

Reference:

• Sehgal A, Mannalithra A, Mithal A, et al. Hip fracture in the extreme elderly: The last frontier of a growing public health problem. Ann Rheum Dis. 2012;71(Suppl3):67