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A meta-analysis of previous fracture and subsequent fracture risk

Kanis, JA; Johnell, Olof LU ; De Laet, C; Johansson, H; Oden, A; Delmas, P; Eisman, J; Fujiwara, S; Garnero, P and Kroger, H, et al. (2004) In Bone 35(2). p.375-382
Abstract
Previous fracture is a well-documented risk factor for future fracture. The aim of this study was to quantify this risk on an international basis and to explore the relationship of this risk with age, sex, and bone mineral density (BMD). We studied 15259 men and 44902 women from 11 cohorts comprising EVOS/EPOS, OFELY, CaMos, Rochester, Sheffield, Rotterdam, Kuopio, DOES, Hiroshima, and two cohorts from Gothenburg. Cohorts were followed for a total of 250000 person-years. The effect of a prior history of fracture on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined were age, sex, and BMD. The results of the different studies were... (More)
Previous fracture is a well-documented risk factor for future fracture. The aim of this study was to quantify this risk on an international basis and to explore the relationship of this risk with age, sex, and bone mineral density (BMD). We studied 15259 men and 44902 women from 11 cohorts comprising EVOS/EPOS, OFELY, CaMos, Rochester, Sheffield, Rotterdam, Kuopio, DOES, Hiroshima, and two cohorts from Gothenburg. Cohorts were followed for a total of 250000 person-years. The effect of a prior history of fracture on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined were age, sex, and BMD. The results of the different studies were merged by using the weighted beta-coefficients. A previous fracture history was associated with a significantly increased risk of any fracture compared with individuals without a prior fracture (RR = 1.86; 95% CI = 1.75-1.98). The risk ratio was similar for the outcome of osteoporotic fracture or for hip fracture. There was no significant difference in risk ratio between men and women. Risk ratio (RR) was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any fracture (8%) and for hip fracture (22%). The risk ratio was stable with age except in the case of hip fracture outcome where the risk ratio decreased significantly with age. We conclude that previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by measurement of BMD. Its validation on an international basis permits the use of this risk factor in case finding strategies. (C) 2004 Elsevier Inc. All rights reserved. (Less)
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publication status
published
subject
keywords
prior fracture, meta-analysis, osteoporotic fracture, hip fracture
in
Bone
volume
35
issue
2
pages
375 - 382
publisher
Elsevier
external identifiers
  • wos:000223027400005
  • pmid:15268886
  • scopus:3242728658
ISSN
1873-2763
DOI
10.1016/j.bone.2004.03.024
language
English
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yes
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7b0e99f3-ff3f-4c2f-a372-e10c11be417f (old id 898628)
date added to LUP
2008-01-15 12:26:35
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2017-11-19 04:04:33
@article{7b0e99f3-ff3f-4c2f-a372-e10c11be417f,
  abstract     = {Previous fracture is a well-documented risk factor for future fracture. The aim of this study was to quantify this risk on an international basis and to explore the relationship of this risk with age, sex, and bone mineral density (BMD). We studied 15259 men and 44902 women from 11 cohorts comprising EVOS/EPOS, OFELY, CaMos, Rochester, Sheffield, Rotterdam, Kuopio, DOES, Hiroshima, and two cohorts from Gothenburg. Cohorts were followed for a total of 250000 person-years. The effect of a prior history of fracture on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined were age, sex, and BMD. The results of the different studies were merged by using the weighted beta-coefficients. A previous fracture history was associated with a significantly increased risk of any fracture compared with individuals without a prior fracture (RR = 1.86; 95% CI = 1.75-1.98). The risk ratio was similar for the outcome of osteoporotic fracture or for hip fracture. There was no significant difference in risk ratio between men and women. Risk ratio (RR) was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any fracture (8%) and for hip fracture (22%). The risk ratio was stable with age except in the case of hip fracture outcome where the risk ratio decreased significantly with age. We conclude that previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by measurement of BMD. Its validation on an international basis permits the use of this risk factor in case finding strategies. (C) 2004 Elsevier Inc. All rights reserved.},
  author       = {Kanis, JA and Johnell, Olof and De Laet, C and Johansson, H and Oden, A and Delmas, P and Eisman, J and Fujiwara, S and Garnero, P and Kroger, H and McCloskey, EV and Mellstrom, D and Melton, LJ and Pols, H and Reeve, J and Silman, A and Tenenhouse, A},
  issn         = {1873-2763},
  keyword      = {prior fracture,meta-analysis,osteoporotic fracture,hip fracture},
  language     = {eng},
  number       = {2},
  pages        = {375--382},
  publisher    = {Elsevier},
  series       = {Bone},
  title        = {A meta-analysis of previous fracture and subsequent fracture risk},
  url          = {http://dx.doi.org/10.1016/j.bone.2004.03.024},
  volume       = {35},
  year         = {2004},
}