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Archives of Osteoporosis

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01-12-2018 | Original Article

Risk factors predicting subsequent falls and osteoporotic fractures at 4 years after distal radius fracture—a prospective cohort study

Authors: Neha Dewan, Joy C. MacDermid, Ruby Grewal, Karen Beattie

Published in: Archives of Osteoporosis | Issue 1/2018

Abstract

Summary

In a prospective cohort of 113 patients followed 4 years after distal radius fracture (DRF), 24% of patients experienced a subsequent fall and 19% experienced a subsequent fracture. People with poor balance, greater fracture-specific pain/disability, low bone density, and prior falls had nearly a three times higher risk of subsequent falls.

Purpose

To determine the extent to which modifiable risk factors alone or in combination with bone mineral density (BMD) and non-modifiable risk factors predict subsequent falls and osteoporotic (OP) fractures after distal radius fracture (DRF).

Methods

We assessed a cohort of patients (n = 191; mean age = 62 ± 8 years; female = 88%) shortly after DRF (baseline) and again at 4 years to identify subsequent falls or OP fractures. Baseline predictors included age, sex, prior falls, and modifiable risk factors such as balance, muscle strength, physical activity, fear of falling, BMD, fracture-specific pain/disability, and general health status. Univariate, multivariate, and stepwise logistic regression analyses were conducted to compute odds ratio (OR) with 95% CI to determine the extent of association between the risk factors and outcomes.

Results

Among the 113 patients, who completed 4-year follow-up, 24% reported ≥ 1 subsequent fall and 19% reported ≥ 1 subsequent fracture. Significant predictors of subsequent falls included poor balance (OR = 3.3), low total hip BMD (OR = 3.3), high patient-rated wrist evaluation (PRWE) score (OR = 3.0), and prior falls (OR = 3.4). When adjusted for BMD, age, and sex; only prior falls (OR = 4.1) remained a significant independent predictor of future falls. None of the modifiable or non-modifiable risk factors were significantly associated with subsequent fractures.

Conclusion

Prior falls (≥ 2) is an independent predictor of subsequent falls in patients with DRF. In clinical practice, screening of patients for prior falls, balance, fracture-specific pain/disability, and BMD may identify those who might be at risk of subsequent falls after their first DRF.

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Title: Risk factors predicting subsequent falls and osteoporotic fractures at 4 years after distal radius fracture—a prospective cohort study
Authors: Neha Dewan
Joy C. MacDermid
Ruby Grewal
Karen Beattie
Publication date: 01-12-2018
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-018-0445-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors predicting subsequent falls and osteoporotic fractures at 4 years after distal radius fracture—a prospective cohort study

Abstract

Summary

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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