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Risk of imminent fracture following a previous fracture in a Swedish database study
Quantify Res, Sweden.
Lund Univ, Sweden; Skane Univ Hosp, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
Uppsala Univ Hosp, Sweden.
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2019 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 30, no 3, p. 601-609Article in journal (Refereed) Published
Abstract [en]

The SummaryThis study examined the imminent risk of a future fracture within 1 and 2years following a first fracture in women aged 50years 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.IntroductionThis study aims to determine the imminent risk of subsequent fractures within 1 and 2years following a first fracture and to assess independent factors associated with subsequent fractures.MethodsRetrospective, observational cohort study of women aged 50years 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 24months following index fracture were calculated. Risk factors for subsequent fracture were identified using multivariate regression analysis.ResultsTwo hundred forty-two thousand one hundred eight women (mean [SD] age 74 [12.5] years) were included. The cumulative subsequent fracture incidence at 12months was 7.1% (95% confidence interval [CI], 6.9-7.2) and at 24months was 12.0% (95% CI, 11.8-12.1). The rate of subsequent fractures was highest in the first month (similar to 15 fractures per 1000 patient-years) and remained steady between 4 and 24months (similar to 5 fractures/1000 patient-years). Higher age was an independent risk factor for imminent subsequent fractures (at 24months, sub-distribution hazard ratio [HR], 3.07; pamp;lt;0.001 for women 80-89years [reference 50-59years]). Index vertebral fracture was a strong independent risk factor for subsequent fracture (sub-distribution HR, 2.72 versus hip fracture; pamp;lt;0.001 over 12months; HR, 2.23; pamp;lt;0.001 over 24months).ConclusionsOur 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.

Place, publisher, year, edition, pages
SPRINGER LONDON LTD , 2019. Vol. 30, no 3, p. 601-609
Keywords [en]
Fracture risk; Fragility fracture; Near-term; Osteoporosis
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:liu:diva-156208DOI: 10.1007/s00198-019-04852-8ISI: 000461576600008PubMedID: 30680431OAI: oai:DiVA.org:liu-156208DiVA, id: diva2:1303220
Note

Funding Agencies|UCB Pharma - UCB Pharma

Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-10-18

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