Risk of Subsequent Fracture After Low-Trauma Fracture in Men and Women

Center, Jacqueline R; Bliuc, Dana; Nguyen, Tuan V.; Eisman, John A.

doi:10.1001/jama.297.4.387

Cited by 595 publications

(491 citation statements)

References 30 publications

Supporting

Mentioning

432

Contrasting

Unclassified

Order By: Relevance

“…(6)(7)(8) In a study of 451 female in-patients aged 60 to 99 years with a fracture of the spine, olecranon, knee, or ankle, Lauritzen and colleagues compared the risk of a subsequent hip fracture with the age-specific incidence of hip fracture of the background population and found that the relative risk was 2.8 (95% CI 1.9-4.1) within 3 years of the primary fracture, and the increased risk then leveled off after 3 years. (8) In another study of 28,869 inpatients, a vertebral fracture was associated with a marked increase in subsequent incidence of hip and all fractures within the first year following the primary vertebral fracture in both men and women; the incidence then declined toward, but did not attain, baseline risk.…”

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

“…Also, in a prospective cohort study of 2245 communitydwelling women and 1760 men aged 60 years (including 905 women and 337 men with a low-trauma fracture such as of the upper limb, vertebra, hip, lower limb, rib, or ankle) living in Australia (Dubbo Osteoporosis Epidemiology Study), (6) 253 women and 71 men suffered a subsequent fracture during a mean follow-up of 4.3 years, giving a refracture rate of 6.2% (95% CI 5.5-7.0) and 5.7% (95% CI 4.5-7.2) per person-year in women and men, respectively. Relative risk (RR) of subsequent fracture was 1.95 (95% CI 1.70-2.25) in women and 3.47 (95% CI 2.68-4.48) in men, and all fracture locations apart from rib (men) and ankle (women) resulted in increased subsequent fracture risk, with the highest RRs following hip (RR ¼ 9.97, 95% CI 1.38-71.98) and clinical vertebral (RR ¼ 15.12, 95% CI 6.06-37.69) fractures in younger men.…”

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

“…Also, we are able to estimate the effect of a current fracture on risk of subsequent fracture accurately by adjusting for differences in baseline characteristics between residents with and without an initial fracture. Most other studies (6)(7)(8) compared refracture rates with the age-and sex-adjusted rates of the general population without adjusting for possible differences in some important aspects between study participants with an initial fracture and the general population, likely resulting in an overestimated risk of subsequent fracture owing to the initial fracture. However, data about risk factors in our study were collected once only at baseline.…”

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

“…It has been well documented that a fragility fracture increases the risk of future fracture in community-dwellers. (6)(7)(8)(9) This increase appears to be greater in the younger age group and in the first few years following a fracture (7,8) but can last up to 10 years. (6) However, it remains unclear whether the increased risk of subsequent fracture also occurs among frail older people with a newly acquired fracture, of whom many already have a history of fracture.…”

Section: Introductionmentioning

confidence: 99%

“…(6)(7)(8)(9) This increase appears to be greater in the younger age group and in the first few years following a fracture (7,8) but can last up to 10 years. (6) However, it remains unclear whether the increased risk of subsequent fracture also occurs among frail older people with a newly acquired fracture, of whom many already have a history of fracture. (10,11) In this study, we investigated the risk of subsequent fracture following a newly acquired low-trauma fracture in a prospective cohort study of older people living in nursing homes and intermediate-care nursing care facilities in Australia.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Low-trauma fractures indicate increased risk of hip fracture in frail older people

Chen

Cameron

Simpson

et al. 2010

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n ¼ 953), the nonhip fracture group (n ¼ 194), and the hip fracture group (n ¼ 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p ¼ .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture. ß

show abstract

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

Section: Risk Of Subsequent Fractures In Older Peoplementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Low-trauma fractures indicate increased risk of hip fracture in frail older people

Chen

Cameron

Simpson

et al. 2010

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

Endogenous Sex Hormones and Incident Fracture Risk in Older Men<subtitle>The Dubbo Osteoporosis Epidemiology Study</subtitle>

Meier

Nguyen²,

Handelsman³

et al. 2008

Arch Intern Med

250

157

View full text Add to dashboard Cite

show abstract

Mortality Risk Associated With Low-Trauma Osteoporotic Fracture and Subsequent Fracture in Men and Women

Bliuc

Nguyen²,

Milch³

et al. 2009

JAMA

Self Cite

1,446

872

View full text Add to dashboard Cite

Context There are few data on long-term mortality following osteoporotic fracture and fewer following subsequent fracture.Objectives To examine long-term mortality risk in women and men following all osteoporotic fractures and to assess the association of subsequent fracture with that risk. Design, Setting, and ParticipantsProspective cohort from the Dubbo Osteoporosis Epidemiology Study of community-dwelling women and men aged 60 years and older from Dubbo, Australia, who sustained a fracture between April 1989 and May 2007.Main Outcome Measures Age-and sex-specific standardized mortality ratios (SMRs) compared with the overall Dubbo population for hip, vertebral, major, and minor fractures. ResultsIn women, there were 952 low-trauma fractures followed by 461 deaths, and in men, 343 fractures were followed by 197 deaths. Age-adjusted SMRs were increased following hip fractures (SMRs, 2.43 [95% confidence interval [CI], 2.02-2.93] and 3.51 [95% CI, 2.65-4.66]), vertebral fractures (SMRs, 1.82 [95% CI, 1.52-2.17] and 2.12 [95% CI, 1.66-2.72]), major fractures (SMRs, 1.65 [95% CI, 1.31-2.08] and 1.70 [95% CI, 1.23-2.36]), and minor fractures (SMRs, 1.42 [95% CI, 1.19-1.70] and 1.33 [95% CI, 0.99-1.80]) for both women and men, respectively.Mortality was increased for all ages for all fractures except minor fractures for which increased mortality was only apparent for those older than 75 years. Increased mortality risk persisted for 5 years for all fractures and up to 10 years for hip fractures. Increases in absolute mortality that were above expected, for 5 years after fracture, ranged from 1.3 to 13.2 per 100 person-years in women and from 2.7 to 22.3 per 100 person-years in men, depending on fracture type. Subsequent fracture was associated with an increased mortality hazard ratio of 1.91 (95% CI, 1.54-2.37) in women and 2.99 (95% CI, 2.11-4.24) in men. Mortality risk following a subsequent fracture then declined but beyond 5 years still remained higher than in the general population (SMR, 1.41 [95% CI, 1.01-1.97] and SMR, 1.78 [95% CI, 0.96-3.31] for women and men, respectively). Predictors of mortality after any fragility fracture for both men and women included age, quadriceps weakness, and subsequent fracture but not comorbidities. Low bone mineral density, having smoked, and sway were also predictors for women and less physical activity for men. ConclusionsIn a sample of older women and men, all low-trauma fractures were associated with increased mortality risk for 5 to 10 years. Subsequent fracture was associated with increased mortality risk for an additional 5 years.

show abstract

Risk of Subsequent Fracture After Low-Trauma Fracture in Men and Women

Cited by 595 publications

References 30 publications

Low-trauma fractures indicate increased risk of hip fracture in frail older people

Low-trauma fractures indicate increased risk of hip fracture in frail older people

Endogenous Sex Hormones and Incident Fracture Risk in Older Men<subtitle>The Dubbo Osteoporosis Epidemiology Study</subtitle>

Mortality Risk Associated With Low-Trauma Osteoporotic Fracture and Subsequent Fracture in Men and Women

Contact Info

Product

Resources

About