An estimated 70–90% of hip fractures are caused by osteoporosis. According to a study of Ontarians aged >65, Hip fracture predicts subsequent hip fracture: a retrospective observational study to support a call to early hip fracture prevention efforts in post fracture patients, prior fracture in older adults is a significant predictor of a subsequent hip fracture, on average within 1.5 years over 2 to 6 years of follow up.
The study results reinforce the importance of early hip fracture prevention strategies focusing on adults aged ≥65 with a recent fracture to help reduce hip fracture risk and the high social and human costs. The healthcare costs associated with hip fractures are predicted to increase to $2.4 billion by 2041 in Canada alone.
Key results of the study included the following:
- A second fracture at the hip was observed in one in four patients after any fracture and in one in three patients with a previous hip fracture, on average within 1.5 years.
- Hip fracture was the most common second fracture (27.8%), occurring in ≥19% of cases after each index fracture site and most frequently (33.0%) after hip index fracture.
- Patients with a hip fracture also accounted for the most deaths, surgeries and post-surgery complications within the first year post-fracture, and 1-year mortality rate after hip fracture was the highest amongst all fracture sites examined.
Likewise, as highlighted in a recent report from the Public Health Agency of Canada, in 2015-2016, <20% of patients with a hip fracture received an osteoporosis diagnosis, underwent a bone mineral density (BMD) test or received a prescription for an osteoporosis-related medication within one year of the fracture
To address some of these issues, Osteoporosis Canada created the Fracture Liaison Service (FLS) that proactively identifies fracture patients and determines their fracture risk to help facilitate effective osteoporosis treatment for high-risk patients. As of June 2019, 46 FLS programs were registered in hospitals across Canada.