# Association of hospital-initiated bone densitometry with hospitalization for fragility fracture at Lille University Hospital among adults with chronic obstructive pulmonary disease

## TL;DR

This study found that only 22.6% of COPD patients hospitalized for a fragility fracture received bone densitometry within a year.

## Contribution

The study provides new insights into the low rate of bone densitometry in COPD patients after fragility fractures.

## Key findings

- Hospital-initiated bone densitometry had a 1-year cumulative incidence of 22.6%.
- Female gender and hospitalization in rheumatology were independent determinants of bone densitometry.
- Most fractures were severe, with hip and vertebral fractures being the most common.

## Abstract

A retrospective study was conducted to calculate the cumulative incidence of hospital-initiated bone densitometry, in the year following hospitalization for fragility fracture in patients with chronic obstructive pulmonary disease. This cohort study demonstrated low rates of hospital-initiated bone densitometry with a 1-year cumulative incidence of 22.6%.

Osteoporosis is one of the most frequent comorbidities in chronic obstructive pulmonary disease (COPD) patients. A study was conducted to assess the management of osteoporosis in COPD patients using the INCLUDE health data warehouse.

The primary objective was to calculate the cumulative incidence of hospital-initiated bone densitometry, in the year following hospitalization for fragility fracture in COPD patients.

A retrospective, monocentric, observational study was conducted at Lille University Hospital with patients identified from January 2013 to December 2021. Patients with COPD, aged 40 or over, and hospitalized for a fragility fracture according to the ICD-10 classification were included. Bone densitometry was indexed according to French Common Procedures Classification (CCAM) acts by INCLUDE.

A total of 365 patients (~ 60% male, mean age 73.5 ± 12.3 years, and median Charlson score 2.0 (1.0; 4.0)) were included. Hospitalization units for fractures were orthopedics (n = 168), geriatrics (n = 46), rheumatology (n = 45), pneumology (n = 24), and others (n = 82). A total of 499 fractures were identified, most of them severe (hip (36.4%), vertebrae (30.1%), proximal humerus (11.5%), pelvis (10.7%), etc.). During the first year, 69 patients (18.9%) died, and 81 underwent hospital-initiated bone densitometry. The cumulative incidence of bone densitometry in the 1st year was 22.6% [CI 95% 18.3–27.1%]. Independent determinants of performing bone densitometry were female gender, low Charlson score, hospitalization in rheumatology, and vertebral fracture(s).

The cumulative incidence of hospital-initiated bone densitometry, within 1 year of hospitalization for a fragility fracture in COPD patients was relatively low.

The online version contains supplementary material available at 10.1007/s11657-025-01534-3.