Programme no. 532-OP
Women with wrist fractures: what is their risk for osteoporosis, their co-morbidity and quality of life?
Katharina Verheijen*1, Anders Möller2, Robert Eggertsen3, Sigvard Mölstad4, Per Hjerpe5, Kristina Bengtsson-Boström6
1Primary care,Bräcke Diakoni Vårdcentralen Vilan Skara,532 21 Skara,Sweden, 2Campus Bräcke,Ersta Sköndal Högskola,Gothenburg,Sweden, 3Primary care,Institute of Medicin,Gothenburg,Sweden, 4Clinical Sciences,Centre for Primary Health Care Research,Malmö,Sweden, 5Närhälsan R&D Primary Care,R&D Center Skaraborg,Skövde,Sweden, 6Närhälsan R&D Primary Care,R&D Center Skaraborg,Skövde,Sweden
* = Presenting author
Objectives: To study a cohort of women with wrist fractures concerning their risk for osteoporosis, future fractures, their co-morbidity and QoL.
Background: Wrist fractures after low energy trauma are common in women and indicate a higher risk for hip- or spine fractures and for osteoporosis which is under diagnosed an undertreated in Sweden. FRAX (WHO Fracture Risk Assessment tool) can be used to identify high risk patients in need for further investigation with BMD (Bone Mineral density) measurement.
Wrist fractures and osteoporosis presumably have negative effect on the patient’s quality of life (QoL) and increase risk for co-morbidity, this should be investigated in order to optimize the care of these patients.
Results: A study of medical records 2010 showed that 11% of these 403 women received a BMD-measurement and/or got treatment for osteoporosis. The questionnaire was answered by 237 women in 2013. Two hundred-six (86,9%) had FRAX >15 indicating high risk of which 51,5% had previous fractures and 80,6% had concurrent diseases. Of the 206 women 30,9% had been investigated for osteoporosis and 33,5% were treated. Symptoms after wrist fracture (pain, stiffness and weakness) were still a complaint in 116 women. QoL is currently analyzed.
Material/Methods: To all women, ≥50 years (n=403) treated 2009 at Skaraborgs hospital for wrist fracture a questionnaire was send in 2013. Information needed to analyze FRAX was collected as well as data on BMD-measurement, treatment for osteoporosis, co-morbidity and current medication. The SF-36 questionnaire was used to evaluate QoL.
Conclusion: Only one third of the women has been investigated and treated 4 years after wrist fracture. This is an increase since the first study but still far from what is recommended by The Swedish National Board of Health and Welfare. Half of the women with FRAX >15 complained about remaining symptoms after fracture, how this affects QoL will be investigated.
Points for discussion:
An increasing interest in care of patients with risk for osteoporosis and future fractures has been noted and organizational arrangements have been inaugurated locally and regionally to encourage detection and increase treatment of these patients. Primary Health Care is one of the stakeholders and discussions of how the care would be arranged to be optimal is mandatory.