Los pacientes con diabetes tipo II tienen mayor riesgo de fracturas subsecuentes más allá del periodo de riesgo inminente: un análisis de supervivencia

Abstract

Introduction: development of subsequent fragility fractures has been linked to previous fractures, age, biological sex and type 2 diabetes mellitus (T2DM). Diabetes may induce osteometabolic disorders that lead to increased fracture risk, relation with subsequent fractures remains unclear. Objective: to establish the impact of previous fractures, age, sex, and type 2 diabetes diagnosis on risk of subsequent fractures in patients who had sustained an index hip fracture in time through a survival analysis. Material and methods: retrospective, observational and descriptive study. From a database of 670 records of patients aged ≥ 50 years who had sustained an index hip fracture between 2014-2017, with follow-up at least two months. Retrieved information: previous fracture, age, sex, diabetes and subsequent fracture. Statistical analysis: central tendency, dispersion, frequency and percentages, t-Student, χ 2 test, Kaplan-Meyer method, log-rank test, Cox regression model. Results: we included 570 patients, mean age 80.09 ± 9.45 years, 79.8% women. Mean follow-up time 24.8 ± 20.8 months. Subsequent fractures on 96 cases, the mean time to subsequent fracture was 25.9 ± 19.5 months; of these 56.2% occurred within two years after incident fracture. No associations were found between previous fracture (p = 0.3), sex (p = 0.265), and diabetes (p = 0.54) for subsequent fractures. Survival analysis only found association for subsequent fractures with diabetes (p = 0.01) and biological sex (p = 0.03). Cox regression analysis model showed an increased risk only for diabetes (HR = 3.8; p = 0.017; 95% CI 1. 275-11.484). Conclusion: patients with type 2 diabetes had an increased risk of developing subsequent fractures in time. Men patients develop subsequent fractures earlier. ResumenIntroducción: las segundas fracturas por fragilidad han sido vinculadas a fracturas previas, edad, sexo y diabetes. La diabetes puede inducir alteraciones osteometabólicas que incrementan el riesgo de fractura, aunque la relación con segundas fracturas no ha sido aclarada. Objetivo: establecer el impacto de fracturas previas, edad, sexo y diabetes tipo 2 en el riesgo de segun-