E-Poster Presentation ESA-SRB-ANZBMS 2021

Hip fracture has a significant contribution to fragility fracture burden in Ontario Canada (#746)

Jeffrey Hassall 1 , Emil Schemitsch 2 , Jonathan D Adachi 3 , Jacques P Brown 4 , Jean-Eric Tarride 5 , Natasha Burke 6 , Thiago Oliveira 6 , Luba Slatkonska 6
  1. Amgen Australia, Sydney, NSW, Australia
  2. Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
  3. St Joseph’s Healthcare, McMaster University, Hamilton, Canada
  4. CHU de Québec (CHUL) Research Centre, Laval University, Quebec City, Canada
  5. Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, Canada
  6. Amgen Canda In, Mississauga, Canada

We conducted a retrospective observational study to examine the contribution of hip fractures to fragility fracture burden in Ontario, Canada. Outcomes included: index and subsequent fracture type and date, patients requiring surgery, 30-day post-surgery complication rate, 1-year mortality rate and total healthcare cost per-patient in the 1st year after index fracture (IF).   

 

115,776 patients were included; median age was 81 (IQR: 74–87) years and 72.3% were female. Hip fracture was the most common IF (27.3%, n=31,613), and 32.4% (n=10,254) of index hip fractures occurred in patients ≤80 years of age. Proportion of IF that were hip fractures by age was: 66-70, 12.1% (n=2,179); 71-75, 17.3% (n=3,092); 76-80, 24.2% (n=4,983); 81-86, 31.2% (n=7,524); and 86+, 39.3% (n=13,835). Hip fracture was also the most common 2nd fracture (27.8%, n=5,745); occurring as the 2nd fracture in ≥19% of cases for all IF sites examined, often after hip (33.0%) or pelvic (32.3%) IF, and least often after tibia/fibula/knee (23.3%) or radius/ulna (19.4%) IFs. Among patients requiring surgery related to their IF (n=44,949) and those experiencing complications 30 days post-surgery (n=8,868), respectively, 64.1% and 71.9% had a hip fracture. One-year all-cause mortality was 26.2% after hip IF and 15.9% in the entire cohort; hip fracture had the highest mortality rate of all IF sites examined, followed by femur (21.9%). Total mean (± SD) healthcare cost per-patient (in 2017 Canadian dollars) in the 1st year after IF was the 2nd highest for hip IF ($62,793 ± 44,438), with femur IF having the highest cost ($65,490 ± 54,116).

 

These data highlight the significant morbidity, mortality and financial burden of hip fragility fractures in adults aged >65 and the urgent need to initiate secondary fracture prevention measures after a fragility fracture occurring at any site to help reduce subsequent hip fracture and associated burden.