[Primary and Secondary Prevention of Hip Fragility Fracture in Teruel Health Sector, Aragon, Spain].

OBJECTIVE: Osteoporosis should be prevented, diagnosed and treated, preferably before the fragility fracture occurs. The objective was to analyze primary and secondary interventions carried out in individuals diagnosed with femur fragility fracture at Teruel in 2014.

METHODS: Descriptive retrospective study. Variables assessed were sex, age, main health district, place of residence, basal functional situation, diagnosis on osteoporosis, hip or vertebral fracture, loss of height, use of FRAX tool, treatment on discharge, survival and cause of exitus. Student's t-test and ANOVA were used for quantitative variables by categories and regression for linear relationships.

RESULTS: 148 patients were included. 123 were women median age was 87 years, 123 (76,4%) were women, 27,4% of the patients were totally or severely dependent for activities of daily living and 33% of them were living in a nursing home. There was a previous history of hip fracture in 10,1%, and one or more vertebral fractures in 10,1%. FRAX® tool was not used in any case. 12,2% of patients had been treated with calcium prior to fracture, 11,5% with vitamin D, and 6,8% of them with antiosteoporotic drugs. Only 52,7% were treated for secondary prevention after discharge. At the end of follow-up, 25,7% of hip fractured patients had died. Median survivorship of deceased patients was 64,5 days. 42,3% of exitus were caused by cardiovascular disease, 23,1% by infection and 11,5% by neoplasms.

CONCLUSIONS: Primary pharmacologic prevention and assessment of osteoporosis or risk of fracture are unfrequent in our health district.. Although pharmacologic treatment is prescribed more frequently in Teruel than in other areas after a hip or vertebral fracture, additional measures should be taken in order to improve fragility fracture prevention.