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The importance of recent prevalent fracture site for imminent risk of fracture – A retrospective, nationwide cohort study of older Swedish men and women
Axelsson, Kristian F. Litsne, Henrik Lorentzon, Mattias
Axelsson, Kristian F.
Litsne, Henrik
Lorentzon, Mattias
Abstract
There is limited evidence regarding which fracture types carry the highest risk for subsequent fracture. The aim of this study was to investigate how the risk of imminent fracture depends on index fracture site. This nationwide retrospective cohort study utilized national registers in Sweden to determine the risk of fracture according to recent (≤2 years) index fracture site and according to an old (>2 years) prevalent fracture compared with the risk observed in controls without a fracture. All Swedes 50 years or older between 2007 and 2010 were included in the study. Patients with a recent fracture were designated a specific fracture group depending on the type of previous fracture. Recent fractures were classified as major osteoporotic fracture (MOF), including fractured hip, vertebra, proximal humerus, and wrist, or non‐MOF. Patients were followed until December 31, 2017, censored for death and emigration, and the risk of any fracture and hip fracture was assessed. A total of 3,423,320 persons were included in the study, 70,254 with a recent MOF, 75,526 with a recent non‐MOF, 293,051 with an old fracture, and 2,984,489 persons with no previous fracture. The median time of follow‐up for the four groups was 6.1 (interquartile range [IQR] 3.0–8.8), 7.2 (5.6–9.4), 7.1 (5.8–9.2), and 8.1 years (7.4–9.7), respectively. Patients with a recent MOF, recent non‐MOF, and old fracture had a substantially increased risk of any fracture (hazard ratio [HR] adjusted for age and sex 2.11, 95% confidence interval [CI] 2.08–2.14; HR 2.24, 95% CI 2.21–2.27; and HR 1.77, 95% CI 1.76–1.78, respectively) compared with controls. All recent fractures, MOFs, and non‐MOFs, as well as older fractures, increase the risk of subsequent fracture, suggesting that all recent fractures should be included in fracture liaison services and that case‐finding strategies for those with older fractures may be warranted to prevent subsequent fractures. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Keywords
fracture risk assessment, fracture prevention, general population studies
Date
2020
Type
Journal article
Journal
Journal of Bone and Mineral Research
Book
Volume
38
Issue
6
Page Range
851-859
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open
Notes
© 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.