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P752 Increased risk of hip fracture in patients with inflammatory bowel disease: a national registry-based nested case–control study

J. Bartko*1, B. Reichardt2, R. Kocijan1, K. Klaushofer1, J. Zwerina1, M. Behanova1

1Ludwig Boltzmann-Institute of Osteology at the Hanusch Hospital of WGKK and Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch Hospital, Vienna, Austria, 2Sickness Fund Burgenland, Burgenländische Gebietskrankenkasse, Eisenstadt, Austria

Background

With rising rates of inflammatory bowel diseases (IBD) in the elderly population, management of co-morbidities such as osteoporosis is becoming increasingly important. Hip fracture is the most serious consequence of low bone mineral density and is associated with significant excess risk of mortality. Although metabolic bone disease is common among patients with IBD, data on fracture risk are limited and current evidence is ambiguous. Therefore, we sought to determine the risk of sustaining a hip fracture in an aged IBD population.

Methods

In a national database-registered nested case–control study, 56821 hip fracture cases (HF) aged ≥50 years and 113718 age-, sex-, and region-matched non-hip fracture controls were analysed. A history of IBD was assessed from data of all Austrian social health insurance funds between 2012 and 2016. Crude and adjusted logistic regression was used to assess the risk of hip fracture.

Results

A total of 531 patients were identified with IBD (25.0% men, mean age 81.2 years, SD 9.7). The prevalence of Crohn’s disease (CD) was 211 and 67 per 100000 among HF cases and controls, respectively. The prevalence of ulcerative colitis (UC) was 299 and 145 per 100000 among HF cases and controls, respectively. Analysis adjusted for anti-osteoporotic treatment and use of glucocorticoids before fracture showed that IBD patients had increased risk of hip fracture (OR 2.37, 95% CI 2.00–2.81), while patients with CD revealed a higher hip fracture risk compared with the UC patients (OR 3.10, 95% CI 2.33–4.14 and OR 2.02, 95% CI 1.63–2.51, respectively).

Conclusion

Aged patients with IBD had twice the risk of hip fracture compared with general population.