Economic burden of hip fracture examined in Turkey
MedWire News: Age, duration of hospital stay, and functional status are the most significant factors determining the economic burden of hip fracture patients attending hospitals in a developing country, Turkish researchers have found.
In contrast, the type of fracture and surgery were not significant predictors of cost for patients attending the Hacettepe University Faculty of Medicine Hospital in Turkey between 2003 and 2006 for hip fracture.
The team examined the economic burden of hip fracture on 50 patients aged an average of 74.2 years, 72% of whom were female. Thirty-two patients sustained intertrochanteric fractures and the remainder had femoral neck (n=17), or subtrochanteric (n=1) fractures. The majority (64%) underwent internal fixation, while 36% underwent arthroplasty, write the researchers in Archives of Gerontology and Geriatrics.
Of note, all but four of the 27 patients with serum 25-hydroxy vitamin D (25OHD) measurements were deficient (defined as below 20 µg/l) in the vitamin. Nineteen of the 45 patients with vitamin D measurements had elevated intact parathyroid hormone (iPTH), despite no evidence of symptomatic hyperparathyroidism, and seven of 47 patients had low levels of thyroid stimulating hormone.
Thirty-two patients had undergone bone mineral density (BMD) testing and 21 were defined as osteoporotic for at least one of the total lumbar, femoral neck, or total femur regions.
BMD T scores significantly and positively correlated with 25OHD levels, while a negative correlation was found for femoral neck and femur T scores with iPTH. No link was determined between BMD and the patients’ dietary or smoking habits, or their activity levels.
The patients had an average hospital expenditure of US$ 5983 (€ 4850), with costs significantly associated with the length of hospital stay, age at time of injury, and time since menopause.
Noting that 34% of patients with BMD measurements showed no evidence of osteoporosis, Mine Tanriover and colleagues comment: “This fact may have reflections on the treatment; not only patients with low BMD and T scores but also patients with risk factors should receive pharmacologic treatment to prevent hip fractures.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Lynda Williams