Morbility and mortality one year after a hip fracture in patients from a health maintenance organization

Morbility and mortality one year after a hip fracture in patients from a health maintenance organization

ABSTRACTS / Bone 43 (2008) S128–S136 be related to BMD or any bone marker or other parameters related to Ca and P metabolism in these patients. Metho...

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ABSTRACTS / Bone 43 (2008) S128–S136

be related to BMD or any bone marker or other parameters related to Ca and P metabolism in these patients. Methods: DNA was isolated from blood samples from 65 TS patients (15 ± 7 y.o.) and 68 healthy individuals (17 ± 8 y.o.). Amplification by PCR and digestion with Bsm I, Apa I and Taq I restriction enzymes were employed. BMD and serum Ca, P, PTH, osteocalcin and β-crosslaps were determined. Results: Genotype distribution corresponding to Bsm I and Taq I sites was similar in b oth TS patients and controls, whereas Apa I genotypes were differently distributed within the two groups (TS: AA 15%, Aa 63,3% vs controls: AA 41,1 %, Aa 37,5%; p < 0,01). Bsm I bb genotype was associated with lower BMD (p = 0,001) whereas the other genotypes did not show any association with BMD. Bone markers and biochemical parameters were similar for all the groups. Seventeen different haplotypes were detected, being the BbAaTt the most frequent. Conclusion: bb genotype is associated with lower BMD in TS patients. Enlarging the number of patients might allow to identify some haplotypes valuable as predictors of bone deterioration.

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stay, number of admissions, admission during the first month and follow up and comorbidities. Results: 126 patients were admitted for a HF in 2006. Baseline characteristics: age 79.4 (8.7) years and female sex 78.5%. Mean follow-up was 1.51 (0.56) years and 1,58 % were lost. In hospital mortality after HF was 1,58% (n = 2), 21.9 % HF patients died during the follow up and 16.2% in the first year. Mortality rate was 14.43 /100 pyear (CI 95% 9,9-21,05). 50.8% of HF patients were hospitalized during the follow up. The HR causes were orthopedic (22,89%), infections (24,09%), cardiovascular (9,64%), deep vein thrombosis 8,43% and others (34,94%). Second HF was observed in 4,76% (n = 6) in the year following the initial HF. In a multivariate analysis the only variables still significant were male sex, age and number of HR with an adjusted hazard ratio (AHR) of 3.01 (1.26-7.2) for male sex, 1.08 (1.02-1.14) for each year age increase and 1.22 (1.08-1.47) for number of admissions. Discussion: Half of the patients required HR and 4,76% had a second HF. doi:10.1016/j.bone.2008.10.015

doi:10.1016/j.bone.2008.10.013 Vitamin D levels on patients with Fibromyalgia Discrepancies in diagnosing Osteopenia and Osteoporosis with bone densitometry at spine and femoral neck H.M. Musacchio, M.A. Vicco, B. Zanuttini, L. César Centro de Tecnología Diagnóstica (Santa Fe, Argentina) – Escuela de Ciencias Médicas (Universidad Nacional del Litoral, Santa Fe-Argentina)

E. Velozo, M. Ceballos Recalde, L. Burgos, S. Rafaelli, J. Rosa, E. Soriano, L. Catoggio, L. Plantalech Secciones Osteopatías Metabólicas y Reumatología, Hospital Italiano de Buenos Aires y Fundación Dr. Pedro M. Catoggio para el Progreso de la Reumatología

The purpose of this study was to determine the correlation in the diagnosis of osteopenia and osteoporosis by bone densitometry in regions femoral neck and spine AP. We studied 3713 female patients with bone densitometry (Lunar DPX-L) in regions femoral neck (F) and spine AP(S)and the Pearson coefficient between the two variables for the whole population and in groups categorized by age (less than 55 years;55 70 years; over 70 years). We categorised the patients in: 1) Significative Osteopenia (OPN; less than-2 DE) and osteoporosis (OPS; less than-2.5 DE). It was determined the percentage of patients who had OPN or OPS in one region and not in the other. We calculated the kappa index between the two categories and bivariate correlation between BMD spine and femoral neck. We studied 3713 patients(age = 59 ± 10 years) with densitometry of both regions. Were classificated as OPN only in S(OPNS;26%) and only in F (OPNF 615 patients;16.6%). OPS was established in any of the 683 regions patients; only in S (OPSS in 586; 15.8%) and only in F (OPSF 255;6.9%) Of the 967 with spine OPN , only 381 (39%) also presented OPN at the hip.Of the 586 with OPS in S, only 158 (27%) also had OPS at the hip. The kappa were 0.35 and 0.31 for S and F respectively. The correlation between BMD in S and F was moderate (r = 0.60);similar results were obtained when analyzing the 3 age groups. The determination of BMD in one region is not suitable for the classification of patients with bone densitometry, and the results were even less reliable in the group of more than 70 years, which showed the lowest correlation between BMD in both regions.

Introduction: Fibromyalgia Syndrome (FMS) is a common disorder affecting mainly women of all ages. Vitamin D (VD) deficiency has been associated with musculoskeletal diffuse chronic pain similar to that occurring in FM. OBJECTIVES: 1-To evaluate VD levels in FMS patients and controls. 2-To correlate levels of VD and bone markers with FMS severity and quality of life. Patients and methods: Consecutive female patients fulfilling ACR 1990 criteria for FMS (60) and a control (CW) group of women (58) with × 47.3 ± 8 y were included between 01/2007 and 03/2008. Both groups fulfilled questionnaires on hours of sun exposure, visual analog scales (VAS) for pain, sleep, FM impact questionnaire (FIQ) and Beck's scale for depression. Serum 25-OH D, PTH, Ca, APh and β cross laps were determined. RESULTS: Mean time from FMS disease onset was 35.9 ± 50.7 m. Mean number of painful points was 16.5 ± 1.6, mean VAS for pain and sleep were 67.7 ± 19.7 and 61.8 ± 23.4 respectively. Mean FIQ and Beck's score was 55.7 ± 16.9 and 15.4 ± 8, without differences between FMS assessed in different seasons. 25OHD serum levels were 19.75 ± 5.6 ng/dl in FMS and 20.60 ± 4.9 ng/dl in CW (NS). FMS had higher levels of PTH (p = 0.001), and APh (p = 0,009) in summer and winter, also were significantly less sun exposed (4vs7hs p = 0.012). FMS with deficiency (25OHD < 10 mg/dl) had higher score on Beck's scale (19.9vs13.4 p = 0,045) than CW. CONCLUSION: There were no differences in serum 25OHD levels between FMS and controls. FMS patients had elevated levels of PTH and A Ph than CW, suggesting prolonged exposure to low levels of vitamin D.FMS patients with VD deficiency were significantly more depressed than patients without.

doi:10.1016/j.bone.2008.10.014

doi:10.1016/j.bone.2008.10.016

Morbility and mortality one year after a hip fracture in patients from a health maintenance organization

Effects of 2 years on bone mineral density and risk of new fracture in different therapeutics schemes of Bisphosphonates in women with Postmenopausal osteoporosis

M. Diehl, A. Beratarrechea, J. Saimovici, N. Pace, S. Figar, E. Langlois, L. Cámera, C. Sancineto, F. Piccaluga, L. Plantalech Hospital Italiano de Buenos Aires

L. Santangelo, R. Guelman, L. Plantalech Endocrinology Department, Hospital Italiano de Buenos Aires

Background: Data on mortality, second hip fracture and hospital readmissions (HR) after a hip fracture (HF) in Argentina are lacking. Methods: Retrospective cohort study. We identified patients admitted for a HF in 2006 from a Health Maintenance Organization, using Electronic Medical Records. The cohort was followed from the date of the HF until death or 01/04/2008. Rates are expressed as 100 persons-year (/100 pyear) and 95% CI. Uni and multivariate proportional hazards Cox models were used for survival analysis; baseline variables included were: age, sex, type of HF, length of

Objective: To asses the better effect of different biphosphonates (BP) in postmenopausal osteoporosis (OPM) on bone mineral density (BMD) and risk of new fx. Methods: 193 OPM (71,4 ± 9y) were selected during 06/04-05/06, and received: alendronate (ale) 70 mg /weekly, pamidronate IV 60 mg/ quarterly, ibandronato IV 3 mg/quarterly or zoledronato (zole) IV 4 mg/year. 33.7% had fracture (FX) before start treatment. They were matched according previous Fx (Pre Fx), Fx during study (Fx T) and without Fx (Without Fx). 21.8% of OPM received previous treatment. Bone turn over was evaluated by