OSTEOPOROTIC FRACTURES OF HIPS, WRISTS AND VERTEBRA WITH COST OF TREATMENT
Abstract
Background. Osteoporosis becomes a serious illness when the patient breaks a bone. Osteoporotic fractures emerge in a larger number after the patients reach age 60 or above. The fracture of the wrist is the earliest osteoporotic fracture, vertebral fracture then follows and it is the most common fracture. The most serious and the most costly fracture is the hip fracture. The analysis of data on fractures of hips in General Hospital Maribor (GHM) between the years 1968 and 2000 has shown that the number of fractures has been steadily increasing from 76 in the year 1968 to 258 in the year 2000. In 1968 the treatment was mainly conservative and the death rate was at 60%. With the introduction of operative treatment, which is being used on 95% of the patients nowadays, the death rate fell to 5%. The cost of acute treatment, as assessed by the Health Insurrance at the end of the year 2000, amounted to 599,360 tolars per case. The cost of the treatment of the vertebral fracture, which has been treated in outpatient’s department in 60% of the cases, amounted to 113,076 per case in the year 2000 in GHM. The cost of wrist fracture treatment, which has been handled in outpatient’s department in 90% of the cases, added up to 30,831 tolars per case.
Conclusions. The osteoporotic fracture of the hip is caused by senile osteoporosis and it affects both men and women equally. That means that the menopausal osteoporosis does not have an important effect on the fracture of the hip. The number of hip fractures is increasing exponentially with the life span lengthening. With the introduction of operative treatment of hip fractures the early mortality decreased from 60% to only 5%. The cost of acute treatment of hip fracture has been three times lower in GHM compared to the same treatment in Great Britain in the year 2000. In 85% of the cases, the fracture of the wrist occurs in women shortly after the age of 60. This confirms the thesis that the menopausal osteoporosis has an important impact on these fractures. The incidence of wrist fracture has been alike in all age groups, that is from 28 to 31 fractures per 1000 women and 3 to 5 fractures per 1000 men. The cost of wrist fracture treatment in GHM has been fourtimes lower than the cost of the same fracture treatment in Great Britain in the year 2000. The incidence of vertebral fracture has been increasing with age and it occurs in 3 to 10 cases per 1000 women and 3 to 14 cases per 1000 men. The cost of vertebral fracture treatment has been two-times lower than the cost of the same injury treatment in Great Britain.
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