Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study

Nymark, Tine; Lauritsen, Jens; Ovesen, Ole; Röck, Niels Dieter; Jeune, Bernard

doi:10.1007/s00198-006-0125-y

Cited by 90 publications

(70 citation statements)

References 15 publications

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“…This is consistent with the clinical audit of the FLS programme at Glasgow, 127 and an extraordinarily high risk of early second hip fracture in a large Danish study. 128 The high rate of early refracture combined with the delayed onset of fracture risk reduction associated with therapies recommended or dispensed within the orthogeriatric and FLS models of care studied here may have contributed to our finding of no impact on refracture risk. In order to detect whether or not the interventions had an impact on longer-term refracture risk, we carried out a post-hoc analysis of second hip fracture risk, in which extended follow-up (when possible) and a time-varying hazards model were used to focus only on risk in the second and third years after a primary hip fracture.…”

Section: Second Hip Fracturementioning

confidence: 77%

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

Judge

Javaid

Leal

et al. 2016

Health Serv Deliv Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms VOLUME 4 ISSUE 28 SEPTEMBER 2016 ISSN 2050 DOI 10.3310/hsdr04280 HEALTH SERVICES AND DELIVERY RESEARCHModels of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England Andrew Judge, M Kassim Javaid, José Leal, Samuel Hawley, Sarah Drew, Sally Sheard, Daniel Prieto-Alhambra, Rachael Gooberman-Hill, Janet Lippett, Andrew Farmer, Nigel Arden, Alastair Gray, Michael Goldacre, Antonella Delmestri and Cyrus Cooper Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England Declared competing interests of authors: Daniel Prieto-Alhambra has received unrestricted research and educational grants from Amgen and Bioibérica S.A. Nigel Arden reports personal fees from Merck Sharp & Dohme (MSD), grants and personal fees from Roche, personal fees from Smith and Nephew, personal fees from Q-Med, personal fees from Nicox, personal fees from Flexion, personal fees from Bioibérica and personal fees from Servier. Cyrus Cooper has received consultancy fees, lecture fees and honoraria from Amgen, GlaxoSmithKline, Alliance for Better Bone Health, Eli Lilly, Pfizer, Novartis, MSD, Servier, Medtronic and Roche. M Kassim Javaid has in the last 5 years received honoraria for travel expenses, speaker fees and/or advisory committees from Lilly UK, Amgen, Servier, MSD, Medtronic, Internis, Consilient Health and Jarrow Formulas. He also serves on the Scientific Committee of the National Osteoporosis Society and International Osteoporosis Foundation. Andrew Judge has received consultancy fees, lecture fees and honoraria from Servier, UK Renal Registry, Oxford Craniofacial Unit, IDIAP Jordi Gol and Freshfields Bruckhaus Deringer, is a member of the Data Safety and Monitoring Board (which involved receipt of fees) from Anthera Pharmaceuticals, Inc., and received consortium research grants from Roche.Published September 2016 DOI: 10.3310/hsdr04280 This report should be referenced as follows:Judge A, Javaid MK, Leal J, Hawley S, Drew S, Sheard S, et al. Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England. Health Serv Deliv Res 2016;4(28). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the repor...

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Section: Second Hip Fracturementioning

confidence: 77%

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

Judge

Javaid

Leal

et al. 2016

Health Serv Deliv Res

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“…Several studies have examined the risk of a second hip fracture associated with a previous hip fracture and have suggested that the risk is highest in the first few years after fracture and subsequently decreases or plateaus. (12)(13)(14)16,29) However, there are conflicting data regarding whether other fractures might cease to become an important risk factor for future fractures. Data from a population-based cohort in Denmark report that patients with a history of hip fracture had a higher relative risk of future hip fracture than controls for 5 years after fracture but was no longer significant 15 years after the first fracture.…”

Section: Discussionmentioning

confidence: 99%

“…(10) Similarly, the time since prior fracture may be important because several studies have suggested that the relative risk of subsequent fracture associated with an index fragility fracture is greatest in the first few years after fracture and that this risk declines over time. (12)(13)(14) However, other data suggest that the risk of a second fracture, particularly hip fractures, may not decrease over time. (15,16) The importance of time since index fragility fracture as a modifier of future fracture risk has implications for the immediate management of patients presenting with fragility fractures.…”

Section: Introductionmentioning

confidence: 99%

Time since prior fracture is a risk modifier for 10-year osteoporotic fractures

Giangregorio

Leslie

2010

Journal of Bone and Mineral Research

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The objective of this study was to assess the importance of time since prior fracture as a risk factor for future osteoporotic fractures and how it affects 10-year fracture rates. We identified 39,991 women 45 years of age or older undergoing baseline bone mineral density (BMD) testing (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)) from a regional database that contains dual-energy X-ray absorptiometry (DXA) results for Manitoba, Canada. Health service records were used to identify nontrauma ICD-9-CM fracture codes preceding DXA, grouped as ''major'' fractures (n ¼ 5178; hip, spine, forearm, and humerus) or ''minor'' fractures (n ¼ 3479; ribs, sternum, pelvis, trunk, clavicle, scapula, patella, tibia/fibula, and ankle). Time since prior fracture was coded in years as less than 1, 1 to 5, 5 to 10, and more than 10. Incident fractures (ie, hip, spine, forearm, and humerus) after BMD testing were identified (mean follow-up 4.2 years, maximum 10 years) and studied in Cox proportionalhazards models adjusted for age, BMD T-score, and other covariates. After BMD testing, n ¼ 1749 (4.4%) women experienced an incident fracture. Prior major fracture was a strong risk factor for incident fracture, greatest risk in the first year [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.60-2.25], declining by more than 10 years (HR 1.62, 95% CI 1.25-2.10). Prior minor fracture was a weaker risk factor, greatest in the first year (HR 1.45, 95% CI 1.13-1.87) and no longer significant by 1 to 5 years. Major and minor fractures both showed a time-dependent decline in importance as risk factors. In conclusion, time since prior fracture modifies future fracture risk, but prior fractures of the hip, spine, forearm, and humerus remain strong risk factors even 10 years later. Fracture risk assessment should emphasize the importance of prior fractures at these sites. ß

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“…For example, a large meta-analysis showed that a prior fracture history was a significant risk factor for hip fracture at all ages but was highest at younger ages and decreased progressively with age [3]. Several studies have examined the time course of second fractures by site following an index fracture [6][7][8][9][10][11][12]. Fracture at the hip, forearm, spine or humerus (collectively termed major osteoporotic fractures) have been less frequently studied but (apart from rib fractures) comprise approximately 90% of the morbidity due to fracture [13,14].…”

Section: Introductionmentioning

confidence: 99%

Imminent risk of fracture after fracture

et al. 2016

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Objectives-A history of fracture is a strong risk factor for future fractures. The aim of the present study was to determine whether the predictive value of a past major osteoporotic fracture (MOF) for future MOF changed with time.Methods-The study was based on a population-based cohort of 18,872 men and women born between 1907 and 1935. Fractures were documented over 510,265 person-years. An extension of Poisson regression was used to investigate the relationship between the first MOF and the second. All associations were adjusted for age and time since baseline.Results-5039 individuals sustained one or more MOF, of whom 1919 experienced a second MOF. The risk of a second MOF after a first increased by 4% for each year of age (95 % CI: 1.02-1.06) and was 41% higher for women than men (95% CI: 1.25-1.59). The risk of a second MOF was highest immediately after the first fracture and thereafter decreased with time though remained higher than the population risk throughout follow-up. For example, 1 year after the first MOF the risk of a second fracture was 2.7 (2.4-3.0) fold higher than the population risk. After 10 years this risk ratio was and 1.4 (1.2-1.6). The effect was more marked with increasing age.Conclusions-The risk of MOF after a first MOF is increased over the whole follow up but the imminent risk is even higher. If the acute increment in risk in the few years following MOF is amenable to therapeutic intervention, then immediate short-term treatments may provide worthwhile clinical dividends in a very cost-effective manner, particularly in the elderly.

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Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study

Cited by 90 publications

References 15 publications

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and cost-effectiveness study within a region of England

Time since prior fracture is a risk modifier for 10-year osteoporotic fractures

Imminent risk of fracture after fracture

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