Effects of anti-osteoporosis therapy on the risk of secondary fractures and surgical complications following surgical fixation of proximal humerus fracture in older people

Abstract Background age-related fragility fractures cause significant burden of disease. Within an ageing society, fracture and complication prevention will be essential to balance health expenditure growth. Objective to assess the effect of anti-osteoporotic therapy on surgical complications and se...

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Bibliographic Details
Published in:Age and ageing 2023-06, Vol.52 (6)
Main Authors: Katthagen, Jan Christoph, Koeppe, Jeanette, Stolberg-Stolberg, Josef, Rischen, Robert, Freistuehler, Moritz, Faldum, Andreas, Raschke, Michael J
Format: Article
Language:English
Subjects:
Age differences
Aged
Aging
Arthroplasty
Complications
Female
Fixation
Fracture Fixation, Internal - adverse effects
Fractures
Health care expenditures
Health insurance
Health status
Humans
Humeral Fractures - complications
Humerus
Legislation
Male
Medical diagnosis
Newly diagnosed
Older people
Osteoporosis
Osteoporosis - complications
Osteoporosis - drug therapy
Regression analysis
Retrospective Studies
Risk reduction
Shoulder Fractures - complications
Shoulder Fractures - surgery
Treatment Outcome
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Summary:Abstract Background age-related fragility fractures cause significant burden of disease. Within an ageing society, fracture and complication prevention will be essential to balance health expenditure growth. Objective to assess the effect of anti-osteoporotic therapy on surgical complications and secondary fractures after treatment of fragility fractures. Patients and methods retrospective health insurance data from January 2008 to December 2019 of patients ≥65 years with proximal humeral fracture (PHF) treated using locked plate fixation (LPF) or reverse total shoulder arthroplasty were analysed. Cumulative incidences were calculated by Aalen–Johansen estimates. The influence of osteoporosis and pharmaceutical therapy on secondary fractures and surgical complications were analysed using multivariable Fine and Gray Cox regression models. Results a total of 43,310 patients (median age 79 years, 84.4% female) with a median follow-up of 40.9 months were included. Five years after PHF, 33.4% of the patients were newly diagnosed with osteoporosis and only 19.8% received anti-osteoporotic therapy. A total of 20.6% (20.1–21.1%) of the patients had at least one secondary fracture with a significant reduction of secondary fracture risk by anti-osteoporotic therapy (P 
ISSN:0002-0729
1468-2834
DOI:10.1093/ageing/afad097