A Comparative Study of 1-Year Mortality Rates in Patients Treated and Untreated with Denosumab Osteoporosis Medication Following Surgery for Fragility Hip Fractures
Keywords:
Fragility hip fracture, Denosumab, Mortality rate, Recurrent fracture, ElderlyAbstract
Fragility hip fracture is the most severe complication of osteoporosis in the elderly, with a 1-year mortality rate as high as 18% in Thailand. This retrospective cohort study aimed to compare the 1-year mortality rate, incidence of recurrent fractures, and associated factors between patients treated and untreated with Denosumab following surgery for fragility hip fractures at Chaophraya Yommarat Hospital, Suphanburi Province. A total of 253 patients operated between January and December 2024 were enrolled, comprising 198 in the non-denosumab group and 55 in the denosumab group. Data were analyzed using Chi-square test and Fisher's exact test at a significance level of 0.05.
The overall 1-year mortality rate was 12.12% in the non-denosumab group and 12.73% in the denosumab group, with no statistically significant difference (P = 0.771). Most deaths occurred within the first 6 months. The 1-year recurrent fracture incidence was 3.03% and 1.82%, respectively (P = 0.984). Age ≥ 80 years was the only factor significantly associated with mortality (OR = 2.26, 95% CI 1.02–5.01, P = 0.050), while recurrent falls were the sole predictor of recurrent fractures (P < 0.001).
Denosumab treatment alone may be insufficient to reduce short-term mortality and recurrent fractures. A holistic approach encompassing pharmacological treatment, comorbidity management, rehabilitation, and fall prevention programs should be emphasized, especially for patients aged 80 years and older.
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