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Background: Falls and fractures are a potentially preventable cause of morbidity in the elderly. Hip fractures, the most serious consequence of falls, are the impetus driving fracture prevention strategies. NICE recommends fracture risk assessment for all elderly patients and those with fracture risk factors. FRAX and QFracture are recommended, but use different risk factors. Notably, FRAX doesn’t incorporate falls as a risk factor. We evaluated fracture risk factors and the predicted 10year fracture risk of hip fracture patients at our centre. Methods: All patients admitted with hip fracture from December 2012 to April 2013 were included. Risk factors for fracture, previous fracture history and history of treatment with bone protection agents were evaluated. Potentially modifiable risk factors were defined as history of falls, previous fracture, known (untreated) osteoporosis, current smoker, daily average alcohol intake greater than 3units, current corticosteroid therapy and BMI <20 kg/m. Fracture risk profiles were performed (looking at the predicted fracture risk prior to the hip fracture). Ten year risks of major osteoporotic and hip fracture were calculated using the FRAX calculator and QFracture2012. Results: Sixty-two patients were included in the study. A fall was the cause of hip fracture in 95% and a prior history of falls was seen in 45%. 31% had a previous history of fracture, 23% a low trauma fracture, and 8% had a personal history of hip fracture. Potentially modifiable risk factors were identified in 74%, and the mean number of modifiable risk factors was 1.9. Table 1 demonstrates the preadmission fracture risk assessment, using the FRAX and QFracture assessment tools. The score was calculated as if the patient’s risk of fracture was being assessed prior to admission with a hip fracture. FRAX score could not be calculated for five patients aged over 90. A QFracture 2012 score could not be calculated for one patient aged over 100 years. Differences in predicted fracture risk score were compared with the Mann Whiney U test. Conclusion: The majority of patients admitted with hip fracture have potentially modifiable risk factors for fracture, and represent a missed opportunity for community fracture risk assessment, and subsequent initiation of bone-sparing treatment. Where no difference is seen in the predicted risk of major fracture, QFracture is more predictive of hip fracture. This may relate to the inclusion of falls as a risk factor for fracture.

200. Hip Fractures Represent a Missed Opportunity for Community Fracture Prevention