The Real Impact of Osteoporosis: 5 Eye-Opening Statistics
X-ray technologists, especially DXA operators, often see patients with bone disease. One of the most common conditions that affects bones is osteoporosis and associated fragility fractures. What is the real impact of osteoporosis on the patient?
The truth is that bone diseases are a burden not only on the affected individual but also the family and society as a whole. Some diseases of the bone are symptomatic and produce deformity and pain. This makes them relatively easier to diagnose. However, many bone diseases tend to be “silent” until they cause fractures. This makes the role of the radiologic technologist especially important. By providing accurate imaging, RTs are in a unique position to reduce the impact of osteoporosis. Here are 5 statistics that might surprise even the most experienced DXA operators and X-ray techs.
1. Osteoporotic Fractures
Approximately 1.5 million fractures occur each year in individuals with osteoporotic bones.
It is estimated that these fractures result in more than 1 million emergency room visits and hospitalizations as well as more than 2.5 million physician encounters. In addition, close to 200,000 patients are placed in nursing homes following osteoporotic fractures. Fractures of the hip are particularly debilitating and account for roughly 300,000 hospital admissions every year. X-ray techs in general and DXA operators in particular can help reduce the impact of osteoporosis by identifying patients who need consultation for treatment.
2. Financial Burden
The total annual direct medical costs associated with hip fractures is $50,000 with a yearly estimate of nearly $6 billion to the U.S. healthcare system.
Hip fractures are the most disabling type of osteoporotic fractures. They are responsible for much of the overall impact of osteoporosis. In addition to the initial treatment, they require prolonged followup care. It is estimated hospitalization and outpatient care costs thousands of dollars in the first year alone. A patient’s overall lifetime cost of medical care as a direct result of a hip fracture can be more than $80,000. Other sites of fracture also cost America billions of dollars in annual healthcare expenditure. In addition to direct healthcare costs, time off from work by patients and caregivers leads to lost productivity.
3. Functional Status
Before a fracture, 86 percent of people are capable of dressing themselves. However, following a fracture, only 49 percent can perform this activity of daily living.
The data from the EPESE project (Established Populations for Epidemiologic Studies of the Elderly) shows that, likewise, pre-fracture, 90 percent of people can stand from sitting in a chair. However, following a fracture, only 32 percent can accomplish this. The ability to walk across a room shows a similar trend of 75 percent pre-fracture and 15 percent post-fracture. This is the functional impact of osteoporosis. Hip fractures have a dramatic effect on ambulation and functional ability, similar to stroke. They render previously independent elderly people dependent on others for many activities of daily living. Reduced mobility due to fractures puts patients at risk of complications such as urinary tract infections, pneumonia, DVT, and pressure ulcers.
4. Emotional Impact
People find ending up in a nursing home with a fracture a less favorable outcome than death.
About 20 percent of patients with hip fractures need nursing home care. Families are unable to provide adequate care and safety at home. In elderly people, an osteoporotic fracture can be the beginning of a downward spiral in health, both physical and mental. Fractures affect a patient’s psychological wellbeing. Mood, body image, and self-esteem can all suffer due to immobility and dependence on others for activities of daily living. This is the psychological impact of osteoporosis. It may be necessary to limit mobility even after a fracture has healed to reduce the risk of falls and additional fractures. Feelings of isolation and helplessness are not uncommon in patients who have suffered osteoporosis-related fractures. This is an often overlooked impact of osteoporosis.
About 1 in 5 patients with a hip fracture dies in the first year following the fracture due to associated complications.
Even in previously ambulatory patients, the risk of death is increased by nearly threefold in the first three months following a hip fracture. This, however, depends on the patient’s pre-fracture health status. Patients with poor health had a higher mortality rate. NHANES data showed a decline in bone density by one standard deviation is associated with an increase in mortality by 10-40 percent. In contrast, the NCHS 1999 survey listed hip fractures as the direct cause of death in less than 13,000 patients. Therefore, the true impact of osteoporosis on the mortality rate can be deceptive. A large number of people are affected by osteoporosis. However, the number of people who die as a direct consequence of this disease is not very high. In the majority of cases, it is an indirect cause of death. Cancer and heart disease are the leading direct causes of mortality.
Impact of Other Bone Diseases
In addition to the impact of osteoporosis, other bone diseases also add to the overall burden. This varies greatly with the incidence of the disease as well as its severity. Osteoporosis, however, has the biggest impact on public health because it affects a large number of people, both patients and caregivers. As noted, some diseases of the bone cause pain or deformity. However, osteoporosis remains “silent” until the individual suffers a fracture. These fractures can lead to a number of complications, as noted above.
The impact of bone diseases is already enormous. Moreover, it is expected to grow in the coming decades. Radiologic technologists play a critical role in the care of patients with fractures. With an aging American population, it is anticipated that the frequency of fractures will increase. X-ray techs and DXA operators, in particular, can help prevent marked functional decline, severe disability, and even death in affected individuals through accurate imaging and referral to consultations in a timely manner.
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