Fractura de cadera por osteoporosis: caídas y calidad del sueño

Abstract

The osteoporotic hip fracture increases the morbidity and mortality. Falls and sleep disorders, not always considered, assessed or prevented, could represent a risk of fracture. Objectives: Analyze the association between osteoporotic hip fractures and falls from upright position or sleep disorders in patients of >40 yrs. of age and the characteristics of the population.

Observational, analytical, transversal study. Inclusion criteria: Patients of >40 yrs. of age diagnosed with acute hip fracture who were hospitalized in Sanatorio Alta Gracia (from 12/01/19 to 05/31/20). Exclusion criteria: Patients with cognitive deterioration, without relatives present at the moment of the study or with advanced cancer. FRAX (fracture risk) and Pittsburgh (sleep quality) indexes; falls from upright position and clinical history were assessed. A bivariate analysis was performed (p<0,05). Statistical procedures for quantitative variables were calculated using measures of centrality and dispersion; for comparing parameters according to fracture risk, Kruskal Wallis test was used; for comparing media, the Student t-test was used; and for other categorical variables, the Chi-square test was used. Approved project CIEIS HNC REPIS No. 3948. The participants signed the informed consent and the researchers had no conflict of interests.

Sample consisting of 22 participants (21 women) of 83 (+-7) yrs. of age with acute hip fracture. 20 participants (90%) fell from upright position after a fracture. The FRAX for major fractures was «high» and «very high»: 11(48%) before the fracture and 16 (72%) after it. The FRAX for hip fracture was «very high» 19 (90%) before the fracture and 22 (100%) after it. Sleep disorders scored 12,9 (SD 3,8), 19 (95%) in patients with poor sleep. 19 (95%) patients with a history of falls were poor sleepers. The study revealed a significant association between medication and falls (p=0,0001) and between sleeping hours and falls (p=0,0049).

Before suffering the hip fractures, such patients presented a high risk of hip fracture and a high risk of major osteoporotic fracture in almost half of the cases; the falls from upright position accelerated the hip fracture; sleep disorders were highly prevalent in these patients and in those who fell.