The Journal of Internal Medicine has published some views on hip fracture. The statistics behind this unfortunate and common injury is ignored as we dispense bisphosphonates to many of our female patients – fearful of the adverse effects after reading about them, and fretting after getting feedback from their friends.
Do we do enough when those early discussions on osteopenia (is that a recently invented disease) start?
Do we chat with the purchaser of high single-dose calcium supplements about coronary artery calcification, and the other issues around poorly-absorbed calcium?
Older people who suffer a hip fracture face a much higher risk of death soon after the injury., but that risk persists over the longer term.
Researchers have found that the risk of dying among people over 60 nearly triples during the first year following a hip fracture.
However, hip fractures are also still linked to a nearly two-fold increased risk of dying eight years or more after the injury.
Post-operative complications, such as cardiac and pulmonary ones, have been mostly implicated for excess short-term mortality after fracture. Those complications include blood clots and pneumonia.
Older hip fracture patients are unlikely to remain physically active and more likely to experience functional decline and disability.
It’s also possible that chronic inflammation develops after a fracture, which could contribute to persistent frailty.
The association between breaking a hip and risk of death seems to be stronger among men.
People with a chronic disease such as heart disease, cancer or diabetes at the time of their hip fracture, face the highest overall death risk.
So, where do we fit in?
Our front line troops (our staff) need to engage. Explain calcium-rich foods, the role of vitamin D, the role of vitamin K2 and the precautions around high single-dose calcium. That should apply to any engagements on calcium or bone health.
Do we know the local occupational therapist to help with fall hazards?
Here’s another opportunity to reinforce our role in reducing costs within the illness system, but more especially, supporting a cohort of people who have a lot of living to do.