Sociodemographic and clinical factors associated with fractures in older adults treated in a public hospital in Paraguay in 2024

Authors

  • Márcia Nayane Da Silva Ayudante de Catedra de Histologia Humana I y Estudiante Investigadora. Núcleo de Investigación en Medicina Traslacional, Universidad María Auxiliadora, Mariano Roque Alonso, PY Author https://orcid.org/0009-0004-7841-7620
  • Rossana Elizabeth Poletti Duarte Docente en Tiempo Completo de la Catedra de Histologia Humana I. Núcleo de Investigación en Medicina Traslacional, Universidad María Auxiliadora, Mariano Roque Alonso, PY Author https://orcid.org/0009-0004-0583-1142
  • Luciana Daniela Garlisi-Torales Coordinadora del Núcleo de Investigación en Medicina Traslacional, Universidad María Auxiliadora, Mariano Roque Alonso, PY Author https://orcid.org/0000-0001-5820-5963
  • Marco A. Chaparro Docente en Tiempo Completo de la Catedra de Anatomía Humana I. Núcleo de Investigación en Medicina Traslacional, Universidad María Auxiliadora, Mariano Roque Alonso, PY Author https://orcid.org/0000-0003-4893-0891

DOI:

https://doi.org/10.62486/sic2026291

Keywords:

bone fracture, elderly, osteoporosis, risk factors, frailty, fall

Abstract

Introduction: Fractures in the elderly constitute a significant public health problem due to their high incidence and impact on morbidity and mortality. Globally, an estimated 178 million fractures occurred in 2019, a number that is increasing due to the aging population. Older adults, especially women, are most susceptible, and most of their fractures are caused by low-energy trauma (falls from standing height). Objective: To identify the factors associated with fractures in older adults treated at a public hospital in Paraguay in 2024. Methodology: A descriptive, cross-sectional observational study. One hundred patients aged ≥60 years with a history of bone fracture, treated at the Trauma Service of a surgical specialty hospital between January and July 2024, were included. Sociodemographic data, comorbidities (hypertension, diabetes), and fracture characteristics (anatomical location, mechanism, type, and treatment) were collected from medical records. Results: The mean age was 76.3±7.9 years (median 77); 78% were female. The average body mass index was ~25 kg/m². Sixty-nine percent had hypertension and 34% had diabetes mellitus. The predominant mechanism was a fall from standing height (84%). The most frequently affected bone was the proximal femur (61%), followed by the distal radius (17%) and the proximal humerus (10%). Ninety-eight percent of the fractures were closed (non-compound), and all received surgical treatment. Discussion: Fragility fractures primarily affected older women with common comorbidities, typically occurring due to low-energy falls and affecting osteoporotic bones (hip, wrist, humerus). These findings are consistent with international literature and highlight the need to prevent falls and implement proactive management of bone health (e.g., treatment of osteoporosis) to reduce the incidence of fractures and their consequences in the elderly population.

References

World Health Organization (WHO). Fragility fractures [Internet]. Ginebra: WHO; 2024 [citado 2025 Sep 09]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/fragility-fractures

Sáez Aldana F, Martínez Galarreta MV, Martínez-Iñíguez Blasco J. Análisis de las caídas productoras de fractura de cadera en el anciano. Rev Esp Cir Ortop Traumatol. 1999;43(2):99-106.

Maldonado DA, Meza-Calvache JM, Gutiérrez C, et al. Fracturas de cadera en adultos mayores: un enfoque actualizado sobre su manejo. LATAM Rev Lat Am Cienc Soc Humanid. 2023;4(4):344–358.

Corrales LA, Parra RO, Farfán H. Perfil epidemiológico de los pacientes adultos mayores de 65 años con fractura de cadera. Rev Colomb Ortop Traumatol. 2021;35(3):188–194.

Torres MQ, García HI, Medina CA. Morbimortalidad en pacientes operados de fractura de cadera. Rev Cuba Ortop Traumatol. 2022;36(3):e1540 [Internet]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2022000300006

Reyes-García R. La enfermedad ósea en el paciente con diabetes: ¿cómo diagnosticarla y tratarla? Rev Diabetes SED. 2022;15(1):30-36

Cervantes CE, Chávez K, Meneses G. Características clínicas y epidemiológicas en adultos mayores con fractura de cadera. Rev Med Hered. 2021;32(1):17-25.

Suárez IDC, Reyes-Sánchez A, Gómez OM. Fractura de cadera como factor de riesgo en la mortalidad en ancianos institucionalizados. Rev Mex Ortop Traum. 2018;32(4):226-232.

Butt DA, Mamdani MM, Austin PC, et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med. 2012;172(22):1739-1744.

Hu Z, Yang K, Hu Z, et al. Determining the association between hypertension and bone metabolism markers in osteoporotic patients. Medicine (Baltimore). 2021;100(24):e26276.

Dawson-Hughes B, Harris SS, Krall EA, et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997;337(10):670-6.

Järvinen TL, Michaëlsson K, Jokihaara J, et al. Overdiagnosis of bone fragility in the quest to prevent hip fracture. BMJ. 2015;350:h2088.

National Institute for Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture. Clinical Guideline CG146. Londres: Royal College of Physicians; 2012 [actualizado 2017; citado 2025 Sep 09]. Disponible en: https://www.nice.org.uk/guidance/cg146.

González MA, Hernández R, Malagón JM, García A, Manrique J. Perfil epidemiológico de los pacientes adultos mayores de 65 años con fractura de cadera. Estudio de Cohorte Transversal. Rev Colomb Ortop Traumatol. 2021;35(3):273-279. doi:10.1016/j.rccot.2021.07.001

Klestil T, Röder C, Stotter C, Winkler B, Nehrer S, Lutz M, Klerings I, Wagner G, Gartlehner G, Nussbaumer-Streit B. Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis. Sci Rep. 2018 Sep 17;8(1):13933. doi:10.1038/s41598-018-32098-7.

Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-81.

Mesa A, Abdo N, González E, et al. Incidencia de la fractura de cadera en el anciano en América Latina. Rev Asoc Argent Ortop Traumatol. 2020;85(2):107-114.

Downloads

Published

2026-01-01

How to Cite

1.
Da Silva MN, Poletti Duarte RE, Garlisi-Torales LD, Chaparro MA. Sociodemographic and clinical factors associated with fractures in older adults treated in a public hospital in Paraguay in 2024. Salud Integral y Comunitaria [Internet]. 2026 Jan. 1 [cited 2025 Nov. 19];4:291. Available from: https://sic.ageditor.org/index.php/sic/article/view/291