Author/Editor		Ferk, Jože
Title		Osteoporotični zlomi kolka, zapestja in hrbteničnega vretenca ter stroški zdravljenja
Translated title		Osteoporotic fractures of hips, wrists and vertebra with cost of treatment
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 1
Publication year		2002
Volume		str. I-41-4
Language		slo
Abstract		Background. Osteoporosis becomes a serious illness when the patient breaks a bone. Osteoporotic fractures emerge in a larger number after the patients reach age 60 or above. The fracture of the wrist is the earliest osteoporotic fracture, vertebral fracture then follows and it is the most common fracture. The most serious and the most costly fracture is the hip fracture. The analysis of data on fractures of hips in General Hospital Maribor (GHM) between the years 2968 and 2000 has shown that the number of fractures has been steadily increasing from 76 in the year 1968 to 258 in the year 2000. In 1968 the treatment was mainly conservative and the death rate was at 60%. With the introduction of operative treatment, which is being used on 95% of the patients nowadays, the death rate fell to 5%. The cost of acute treatment, as assessed by the Health Insurrance at the end of the year 2000, amounted to 599,360 tolars per case. The cost of the treatment of the vertebral fracture, which has been treated in outpatient's department in 60% of the cases, amounted to 113,076 per case in the year 2000 in GHM. The cost of wrist fracture treatment, which has been handled in outpatient's department in 90% of the cases, added up to 30, 831 tolars per case. Conclusions. The osteoporotic fracture of the hip is caused by senile osteoporosis and it affects both men and women equally. That means that the menopausal osteoporosis does not have an important effect on the fracture of the hip. The number of hip fractures is increasing exponentially with the life span lengthening. With the introduction of operative treatment of hip fractures the early mortality decreased from 60% to only 5%. The cost of acute treatment of hip fracture has been three times lower in GHMcompared to the same treatmentin Great Britain in the year 2000. In 85% of the cases, the fracture of the wrist occurs in women shortly after the age of 60. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Osteoporoza postane resna bolezen, ko pride do zloma kosti. Osteoporotični zlomi se začnejo v večjem številu pojavljati po 60. letu starosti. Zlom zapestja je najzgodnejši, sledi mu zlom hrbteničnega vretenca, ki je najštevilčnejši, po 70. letu starosti pa se pojavljajo zlomi kolkov, ki so najresnejše in najdražje posledice osteoporoze. Analiza podatkov o zlomih kolkov pri starostnikih v Splošni bolnišnici Maribor (SBM) od leta 1968 do leta 2000 je pokazala, da je število zlomov v tem obdobju naraščalo in se je povzpelo od 76 na 258 letno. Leta 1968 je bilo zdravljenje pretežno konservativno, zato je bila zgodnja smrtnost do 60%. S postopnim uvajanjem operativnega zdravljenja, ki ga je sedaj deležnih 95% bolnikov, je zgodnja smrtnost padla na okrog 5%. Stroški akutnega zdravljenja, ki je bilo bolnišnično in operativno, ovrednoteni po merilih Zavoda za zdravstveno zavarovanje Slovenije (ZZZS) konec leta 2000, so znašali 599.360 tolarjev po primeru. Stroški zdravljenja zloma hrbteničnega vretenca, ki je bilo v 60% ambulantno, so znašali konec leta 2000 v SBM 123.076 tolarjev po primeru. Stroški zdravljenja zloma zapestja, ki je bilo v 90% ambulantno, so bili najnižji in so znašali 30.831 tolarjev po primeru. Zaključki. Zlom kolka je posledica senilne osteoporoze in v enaki meri prizadene moške in ženske, kar pomeni, da menopavzna osteoporoza nima posebnega vpliva na nastanek zloma kolka. Zaradi daljšanja povprečne življenjske dobe število zlomov kolkov narašča, ker se incidenca zlomov s starostjo veča eksponenčno pri ženskah in moških. Z operativnim zdravjenjem zlomov kolkov se je zgodnja smrtnost zmanjšala s 60% na okrog 5%. Stroški akutnega zdravljenja zloma kolka so bili u Splošni bolnišnici Maribor konec leta 2000 trikrat nižji kot v Veliki Britaniji. Do zloma zapestja pride v 85% pri bolnicah in se pojavlja že po 60. letu starosti, kar potrjujejo tezo, da ima na te zlome menopavzna osteoporoza odločilen vpliv. (Izvleček prekinjen pri 2000 znakih).
Descriptors		OSTEOPOROSIS HIP FRACTURES SPINAL FRACTURES WRIST INJURIES FRACTURES, SPONTANEOUS AGED HEALTH CARE COSTS FRACTURE FIXATION FEMORAL NECK FRACTURES