SUN-384 A Dedicated Primary Fracture Prevention Program Decreased Low Trauma Hip Fracture Rates over Six Years

Abstract

BACKGROUND: Improvements in secondary prevention of osteoporotic fractures are widely reported following the dissemination of Fracture Liaison Services, however, few models for the primary prevention of such fractures have been described. Available published data indicates osteoporosis screening rates in the United States, most significantly in men, remain consistently less than 20% (Cheng N, Green ME). We have previously published how an interdisciplinary Bone Health Team (BHT) improves screening and treatment initiation rates in the outpatient setting. Here we describe the changes in low trauma hip fracture hospitalizations in the six years since initiation of BHT screenings.METHODS: The BHT began osteoporosis screening in February 2013. Hip fracture admission rates at our facility for each year starting in 2007 were assessed utilizing codes ICD 9 820*/ICD 10 S72.*; our facility is not a trauma center and receives no trauma injuries. Data was divided into a period from October 2007 to September 2013 and October 2013 to September 2019, the latter period based upon the average timeline from identification to treatment initiation and expected efficacy for the first screening group.RESULTS: From October 2007 to September 2013 there were 216 individuals admitted with a new hip fracture diagnosis, representing 0.54% of the averaged 40,362 individuals served by our facility during that time. Ages ranged from 48 to 94 years, with 156 (72.2% of fractures; 0.39% of all individuals) of individuals meeting age-based screening criteria (aged ≥65 for women and ≥70 for men) at time of fracture. Nine individuals with hip fractures had greater than one discrete hip fracture, confirmed as separate by chart review.From October 2013 to September 2019 there were 156 individuals admitted with a new hip fracture diagnosis, representing 0.37% of the averaged 46,327 individuals during that time. Ages ranged from 26 to 99 years. Of the hip fractures, 110 (70.5% of fractures) were in individuals meeting age-based screening criteria representing 0.24% of the averaged total individuals served and a 38.5% decrease (p<0.0001) in hip fracture admissions when compared to the prior six years. One individual had greater than one discrete hip fracture, representing an 88.9% lower rate (p<0.0001) of repeated fractures compared to the prior timeframe.Men represented 355 (95.4%) of the 372 fractures seen from 2007 to 2019. CONCLUSION: A statistically significant decrease in hip fracture admission rates in women aged ≥65 and men ≥70 and in repeat hip fractures was observed in the 6 years since BHT inception compared to the 6 years prior.