Risk factors of refracture after a fragility fracture in elderly

Sriruanthong, Kaiwan; Philawuth, Nattaphon; Saloa, Surapot; Daraphongsataporn, Nuttorn; Sucharitpongpan, Worapong

doi:10.1007/s11657-022-01143-4

Cited by 11 publications

(8 citation statements)

References 33 publications

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“…As has been evidenced, old age can independently affect subsequent contralateral hip fractures ( 12 , 14 , 22 ). Our study shows that the odds ratio increases by 1.09 for each additional year after 60 years old.…”

Section: Discussionmentioning

confidence: 91%

Development and validation of a predictive nomogram for subsequent contralateral hip fracture in elderly patients within 2 years after hip fracture surgery

Liang,

Zhang,

Lou

et al. 2023

Front. Med.

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PurposeContralateral hip refracture following initial hip fracture surgery is life-threatening in the elderly with high incidence and mortality. This study investigated the associated independent risk factors and established a nomogram prediction model.MethodsTotally 734 elderly patients with hip fractures who underwent surgical treatment (January 2016–December 2020) were enrolled. Following analyses on demographic variables, clinical characteristics, and laboratory examination, independent risk factors of contralateral hip fractures in the elderly were identified through the least absolute shrinkage and selection operator (LASSO) regression, and univariate and multivariate logistic regression. Patients were randomly allocated into training (n = 513) and validation sets (n = 221). A training set-based nomogram prediction model was established and assessed for predictability, discriminatory ability, and clinical applicability using the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) in both sets.ResultsContralateral hip refractures occurred in 7.08% (52/734) patients within 2 years after surgery. Age, hemoglobin (Hb), heart disease, neurovascular disease, Parkinson’s disease (PD), Alzheimer’s disease (AD), chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD) were independent risk factors. The nomogram prediction model had a favorable discriminatory ability, as indicated by the areas under the ROC curves (AUC): 0.906 (95% CI, 0.845–0.967) in the training set and 0.956 (95% CI, 0.927–0.985) in the validation set. The calibration curves demonstrated a good consistency between the actual subsequent contralateral hip fracture incidence and the predicted probability. The DCA of the nomogram demonstrated the model’s excellent clinical efficacy.ConclusionThe nomogram model enabled accurate individualized prediction for the occurrence of subsequent contralateral hip fracture in the elderly within 2 years after surgical treatment, which might help clinicians with precise references for appropriate perioperative management and rehabilitation education following initial hip surgery for their patients.

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Section: Discussionmentioning

confidence: 91%

Development and validation of a predictive nomogram for subsequent contralateral hip fracture in elderly patients within 2 years after hip fracture surgery

Liang,

Zhang,

Lou

et al. 2023

Front. Med.

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“…The most common fragility fractures are hip fractures, vertebral compression fractures, distal forearm fractures, and proximal humeral fractures [ 2 ]. A patient who has sustained 1 fragility fracture is at high risk of experiencing secondary fractures, especially in the first 2 years following the initial fracture [ 3 ]. The global trend of an aging society has been recognized and concern among healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

The optimal cut-off values of FRAX without BMD for predicting osteoporosis fracture risk in the older adults at Nan, Thailand

Sucharitpongpan

2024

Osteoporosis and Sarcopenia

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“… 9 The incidence of hip fractures is expected to constantly increase worldwide, 3 , 7 , 10 and the hip is the most common site of a second FF. 11 Most of these refractures could be observed early in the 3–4 years after the first FF. 11 The occurrence of a second FF further affects patients’ disability and DALYs, and therefore their prevention must be a priority for healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

“… 11 Most of these refractures could be observed early in the 3–4 years after the first FF. 11 The occurrence of a second FF further affects patients’ disability and DALYs, and therefore their prevention must be a priority for healthcare systems. 11 , 12 To reduce the incidence of a second FF, several prevention programs have been proposed, and good outcomes were reported in terms of both mortality and treatment adherence.…”

Section: Introductionmentioning

confidence: 99%

“… 11 The occurrence of a second FF further affects patients’ disability and DALYs, and therefore their prevention must be a priority for healthcare systems. 11 , 12 To reduce the incidence of a second FF, several prevention programs have been proposed, and good outcomes were reported in terms of both mortality and treatment adherence. 12 – 32 The fracture liaison service (FLS) is one of the proposed models to effectively manage a patient with an FF.…”

Section: Introductionmentioning

confidence: 99%

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The role of the fracture liaison service in the prevention of atypical femoral fractures

Toro,

Braile,

Liguori

et al. 2023

Therapeutic Advances in Musculoskeletal

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Osteoporosis and fragility fractures (FFs) are considered critical health problems by the World Health Organization (WHO) because of high morbidity, mortality, and healthcare costs. The occurrence of a FF raises the risk of a subsequent fracture (refracture). The hip is the most common site of fragility refracture, and its onset is associated with a further increase in patient’s morbidity, mortality, and socioeconomic burden. Therefore, the prevention of refracture is essential. In this context, fracture liaison service (FLS) demonstrated to be able to reduce FF risk and also improve patients’ adherence to anti-osteoporotic treatments, particularly for bisphosphonates (BPs). However, long-term and high adherence to BPs may lead to atypical femoral fractures (AFFs). These latter are tensile side stress fractures of the femur, with high rates of complications, including delayed and non-healing. An effective FLS should be able to prevent both FF and AFF. A comprehensive and interdisciplinary approach, through the involvement and education of a dedicated team of healthcare professionals (i.e. orthopedic, geriatrician, primary care physician, rehabilitation team, and bone nurse) for evaluating both FF and AFF risks might be useful to improve the standard of care.

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Risk factors of refracture after a fragility fracture in elderly

Cited by 11 publications

References 33 publications

Development and validation of a predictive nomogram for subsequent contralateral hip fracture in elderly patients within 2 years after hip fracture surgery

Development and validation of a predictive nomogram for subsequent contralateral hip fracture in elderly patients within 2 years after hip fracture surgery

The optimal cut-off values of FRAX without BMD for predicting osteoporosis fracture risk in the older adults at Nan, Thailand

The role of the fracture liaison service in the prevention of atypical femoral fractures

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