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Bisphosphonate Use After Hip Fracture in Older Adults : A Nationwide Retrospective Cohort Study

Nordström, Peter; Toots, Annika; Gustafson, Yngve; Thorngren, Karl Göran LU ; Hommel, Ami LU and Nordström, Anna (2017) In Journal of the American Medical Directors Association
Abstract

Objectives: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age. Design, setting, and participants: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals. Main outcome measure: A new hip fracture. Results: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy,... (More)

Objectives: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age. Design, setting, and participants: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals. Main outcome measure: A new hip fracture. Results: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05). Conclusion: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Bisphosphonates, Cohort study, Hip fractures, Older individuals
in
Journal of the American Medical Directors Association
publisher
Elsevier
external identifiers
  • scopus:85013414268
  • wos:000402431200009
ISSN
1525-8610
DOI
10.1016/j.jamda.2016.12.083
language
English
LU publication?
yes
id
ad8464ad-515b-48c4-836c-4b84aed8bc17
date added to LUP
2017-03-16 08:18:52
date last changed
2017-09-18 11:32:42
@article{ad8464ad-515b-48c4-836c-4b84aed8bc17,
  abstract     = {<p>Objectives: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age. Design, setting, and participants: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals. Main outcome measure: A new hip fracture. Results: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05). Conclusion: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.</p>},
  author       = {Nordström, Peter and Toots, Annika and Gustafson, Yngve and Thorngren, Karl Göran and Hommel, Ami and Nordström, Anna},
  issn         = {1525-8610},
  keyword      = {Bisphosphonates,Cohort study,Hip fractures,Older individuals},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {Journal of the American Medical Directors Association},
  title        = {Bisphosphonate Use After Hip Fracture in Older Adults : A Nationwide Retrospective Cohort Study},
  url          = {http://dx.doi.org/10.1016/j.jamda.2016.12.083},
  year         = {2017},
}