Assessment of risk factors and occurrence of osteoporotic fractures among low impact trauma clients in West Bengal, India

Abstract

Management of osteoporotic fractures becomes challenging because of its multiple associated factors as well as poor bone quality. Therefore, assessments of the risk factors of osteoporotic fractures among low impact trauma client is a matter of great concern which can be addressed properly to reduce their occurrence in future. Thirty patients with single or multiple fractures were selected purposively for descriptive survey study between January 2018 to December 2018. Their ages varied from 41 to 80 years. There were 26 female and four males. 24 patients have single fracture and six had multiple fractures following low impact trauma. The demographic parameters were studied by structured interview schedule, and the research variable, the risk factors were studied by interview, biophysical assessment and records of BMD value through DEXA and serum level of vitamin D. Socio-demographic variables like age, sex, body weight, Body mass index (BMI), etc. were selected and their relationship were assessed to find out the risk factors of fragility fractures in society by research variables like risk factors of osteoporotic fractures. For statistical analysis of determination of association between such factors and fragility fractures, non-parametric Fisher exact test and Odds ratio was used. In our study, osteoporotic fractures occurred majority (86.66%) among female maximally among 60-69 years age group. Whereas in relatively younger age (40-60 years), abnormal BMI (low or high) is responsible for fragility fracture as 46.6% of such fractures occurred in this group as 20% fracture are associated with underweight and 40.66% with overweight BMI. Tobacco smoking increases the risk of fragility fractures twice (as relative risk ratio 2) and rheumatoid arthritis increases the six-fold (as relative risk ratio 6). All 100% had history of fall. Level of serum vitamin D, low DEXA scan value (less than -2.5) and fall on ground resulting in low impact injuries shows strong association between those and fragility fractures. On the other hand, all the risk factors remain same for the recent and old fractures. Several risk factors need to be addressed properly apart from medical managements to reduce the risk of occurrence of osteoporotic fractures.