Rheumatoid arthritis is a risk factor for refracture in patients with fragility fractures

Abstract

Objectives To determine whether patients with rheumatoid arthritis (RA) who have had fragility fractures are at an increased risk of refractures. Methods Patients with fragility fractures who were treated surgically at ten hospitals from 2008 to 2017 and who underwent follow-up for more than 24 months were either categorized into a group comprising patients with RA or a group comprising patients without RA (controls). The groups were matched 1:1 by propensity score matching. Accordingly, 240 matched participants were included in this study. The primary outcome was the refracture rate in patients with RA as compared to in the controls. Multivariable analyses were also conducted on patients with RA to evaluate the odds ratios (ORs) for the refracture rates. Results Patients with RA were significantly associated with increased rates of refractures during the first 24 months (OR: 2.714, 95% confidence interval [95% CI]: 1.015–7.255; P = 0.040). Multivariable analyses revealed a significant association between increased refracture rates and long-term RA (OR: 6.308, 95% CI: 1.195–33.292; P=0.030). Conclusions Patients with RA who have experienced fragility fractures are at an increased risk of refractures. Long-term RA is a substantial risk factor for refractures.

Machine Learning Algorithms: Prediction and Feature Selection for Clinical Refracture after Surgically Treated Fragility Fracture

“…Feature importance in our study showed the several potential predictors for clinical refractures, which can be divided into two groups. First, a group contained the items already detected by previous reports [ 9 , 28 ]. RA and no post-operative treatments for osteoporosis correspond to this.…”

“…RA was also detected as a relevant feature for clinical refracture, and RA is known to be a risk factor for refracture as well as fracture [ 7 , 9 ]. Osteoclasts are the main cell population responsible for bone loss in patients with RA [ 42 ].…”

“…To prevent refractures, fracture liaison services have been established, and risk factors for refractures have been investigated [ 5 , 7 ]. Recent studies have reported that patients with rheumatoid arthritis (RA), multiple fractures history, and old aged women are at an increased risk of fracture [ 6 , 8 , 9 ]. Although those predictors for refracture were crucial when managing patients with fragility fracture, no literature has reported on prediction models by machine learning algorithms for clinical refractures, to our knowledge.…”