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Risk of imminent fracture following a previous fracture in a Swedish database study

Banefelt, J.; Åkesson, K. E. LU ; Spångéus, A.; Ljunggren, O.; Karlsson, L.; Ström, O.; Ortsäter, G.; Libanati, C. and Toth, E. (2019) In Osteoporosis International 30(3). p.601-609
Abstract

Summary: This study examined the imminent risk of a future fracture within 1 and 2 years following a first fracture in women aged 50 years and older and assessed independent factors associated with risk of subsequent fractures. The study highlights the need to intervene rapidly after a fracture to prevent further fractures. Introduction: This study aims to determine the imminent risk of subsequent fractures within 1 and 2 years following a first fracture and to assess independent factors associated with subsequent fractures. Methods: Retrospective, observational cohort study of women aged ≥ 50 years with a fragility fracture was identified from Swedish national registers. Clinical/demographic characteristics at the time of index... (More)

Summary: This study examined the imminent risk of a future fracture within 1 and 2 years following a first fracture in women aged 50 years and older and assessed independent factors associated with risk of subsequent fractures. The study highlights the need to intervene rapidly after a fracture to prevent further fractures. Introduction: This study aims to determine the imminent risk of subsequent fractures within 1 and 2 years following a first fracture and to assess independent factors associated with subsequent fractures. Methods: Retrospective, observational cohort study of women aged ≥ 50 years with a fragility fracture was identified from Swedish national registers. Clinical/demographic characteristics at the time of index fracture and cumulative fracture incidences up to 12 and 24 months following index fracture were calculated. Risk factors for subsequent fracture were identified using multivariate regression analysis. Results: Two hundred forty-two thousand one hundred eight women (mean [SD] age 74 [12.5] years) were included. The cumulative subsequent fracture incidence at 12 months was 7.1% (95% confidence interval [CI], 6.9–7.2) and at 24 months was 12.0% (95% CI, 11.8–12.1). The rate of subsequent fractures was highest in the first month (~ 15 fractures per 1000 patient-years) and remained steady between 4 and 24 months (~ 5 fractures/1000 patient-years). Higher age was an independent risk factor for imminent subsequent fractures (at 24 months, sub-distribution hazard ratio [HR], 3.07; p < 0.001 for women 80–89 years [reference 50–59 years]). Index vertebral fracture was a strong independent risk factor for subsequent fracture (sub-distribution HR, 2.72 versus hip fracture; p < 0.001 over 12 months; HR, 2.23; p < 0.001 over 24 months). Conclusions: Our findings highlight the need to intervene rapidly after any fragility fracture in postmenopausal women. The occurrence of a fragility fracture provides healthcare systems with a unique opportunity to intervene to reduce the increased risk of subsequent fractures.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Fracture risk, Fragility fracture, Near-term, Osteoporosis
in
Osteoporosis International
volume
30
issue
3
pages
601 - 609
publisher
Springer
external identifiers
  • scopus:85060690396
ISSN
0937-941X
DOI
10.1007/s00198-019-04852-8
language
English
LU publication?
yes
id
2b50ace3-3d3c-4f4a-834a-2cfb57b0a597
date added to LUP
2019-02-06 14:13:02
date last changed
2019-08-14 04:32:03
@article{2b50ace3-3d3c-4f4a-834a-2cfb57b0a597,
  abstract     = {<p>Summary: This study examined the imminent risk of a future fracture within 1 and 2 years following a first fracture in women aged 50 years and older and assessed independent factors associated with risk of subsequent fractures. The study highlights the need to intervene rapidly after a fracture to prevent further fractures. Introduction: This study aims to determine the imminent risk of subsequent fractures within 1 and 2 years following a first fracture and to assess independent factors associated with subsequent fractures. Methods: Retrospective, observational cohort study of women aged ≥ 50 years with a fragility fracture was identified from Swedish national registers. Clinical/demographic characteristics at the time of index fracture and cumulative fracture incidences up to 12 and 24 months following index fracture were calculated. Risk factors for subsequent fracture were identified using multivariate regression analysis. Results: Two hundred forty-two thousand one hundred eight women (mean [SD] age 74 [12.5] years) were included. The cumulative subsequent fracture incidence at 12 months was 7.1% (95% confidence interval [CI], 6.9–7.2) and at 24 months was 12.0% (95% CI, 11.8–12.1). The rate of subsequent fractures was highest in the first month (~ 15 fractures per 1000 patient-years) and remained steady between 4 and 24 months (~ 5 fractures/1000 patient-years). Higher age was an independent risk factor for imminent subsequent fractures (at 24 months, sub-distribution hazard ratio [HR], 3.07; p &lt; 0.001 for women 80–89 years [reference 50–59 years]). Index vertebral fracture was a strong independent risk factor for subsequent fracture (sub-distribution HR, 2.72 versus hip fracture; p &lt; 0.001 over 12 months; HR, 2.23; p &lt; 0.001 over 24 months). Conclusions: Our findings highlight the need to intervene rapidly after any fragility fracture in postmenopausal women. The occurrence of a fragility fracture provides healthcare systems with a unique opportunity to intervene to reduce the increased risk of subsequent fractures.</p>},
  author       = {Banefelt, J. and Åkesson, K. E. and Spångéus, A. and Ljunggren, O. and Karlsson, L. and Ström, O. and Ortsäter, G. and Libanati, C. and Toth, E.},
  issn         = {0937-941X},
  keyword      = {Fracture risk,Fragility fracture,Near-term,Osteoporosis},
  language     = {eng},
  month        = {01},
  number       = {3},
  pages        = {601--609},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Risk of imminent fracture following a previous fracture in a Swedish database study},
  url          = {http://dx.doi.org/10.1007/s00198-019-04852-8},
  volume       = {30},
  year         = {2019},
}