THU423 Recognizing Secondary Contributors Of Osteoporosis In A Hip Fracture Cohort In Singapore

Abstract

Abstract Disclosure: W. Tay: None. T.Y. Donovan: None. Osteoporotic fractures pose a considerable burden on a country’s healthcare system. Identifying and managing secondary contributors is essential in optimizing the response to osteoporosis treatment. The reported prevalence of secondary osteoporosis is heterogeneous and maybe country-specific and recommendations on screening for these contributors in guidelines are variable. Knowing the frequency of underlying disorders can facilitate development of suitable and cost-effective recommendations specific to a population. We aimed to examine the prevalence of secondary contributors of osteoporosis in a multi-ethnic cohort of Singaporean women and men presenting with hip fracture and to also identify the extent of treatment gap. A retrospective cohort study of 493 consecutive adult patients admitted to a regional hospital in Singapore for a hip fracture were evaluated for secondary contributors. All patients were enrolled in a standard electronic hip fracture clinical pathway. Laboratory investigations were standardised. Deidentified data was extracted from the electronic health intelligence system (eHINTS) using the Oracle Business Intelligence and Enterprise Edition (OBIEE) software. The eHINTS is a data repository that consolidates healthcare, operational and finance data from multiple healthcare system uploaded on the web-based business intelligence software. Demographics, clinical data and laboratory investigations, bone mineral density and current medication were extracted. Approval was obtained from the centralized institutional board of our institution. The mean age of the cohort was 78 ±11 years. The majority (67.3%) of the cohort were female. Mean BMI was 22.3± 9.2 kg/m2. The mean T score at the lumbar spine was -1.87± 1.55; total hip -2.32±1.42; femoral neck -2.50 ± 1.28. 45.2% of the cohort had at least a secondary contributor of osteoporosis. 30.6% had vitamin deficiency (25OHD <20µg/L). 12.2% were on at least 1 medication implicated in the pathogenesis of osteoporosis such as aromatase inhibitors, glucocorticoids, anti-epileptics, levothyroxine, anti-depressants, warfarin, gonadotropin-releasing hormone (GnRH) therapy. 6.9% had primary hyperparathyroidism. 2.6% had primary hyperthyroidism. In male patients, 2.5% had hypogonadism. 1 patient had hypercalciuria. 13.6% had a BMD done prior to the hip fracture admission and only 11.8% of patients were on osteoporosis treatment prior to admission. Secondary contributors to osteoporosis are common and this should be considered in the evaluation of patients presenting with hip fractures. A significant treatment gap still exists and future studies should address the reasons behind the treatment inertia. Presentation: Thursday, June 15, 2023