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Osteoporosis International
Published in: Osteoporosis International 7/2016

01-07-2016 | Original Article

Second fractures among older adults in the year following hip, shoulder, or wrist fracture

Authors: J. P. W. Bynum, J.-E. Bell, R. V. Cantu, Q. Wang, C. M. McDonough, D. Carmichael, T. D. Tosteson, A. N. A. Tosteson

Published in: Osteoporosis International | Issue 7/2016

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Abstract

Summary

We report on second fracture occurrence in the year following a hip, shoulder or wrist fracture using insurance claims. Among 273,330 people, 4.3 % had a second fracture; risk did not differ by first fracture type. Estimated adjusted second fracture probabilities may facilitate population-based evaluation of secondary fracture prevention strategies.

Introduction

The purpose of this study was estimate second fracture risk for the older US population in the year following a hip, shoulder, or wrist fracture.

Methods

Observational cohort study of Medicare fee-for-service beneficiaries with an index hip, shoulder, or wrist fragility fracture in 2009. Time-to-event analyses using Cox proportional hazards models to characterize the relationship between index fracture type (hip, shoulder, wrist) and patient factors (age, gender, and comorbidity) on second fracture risk in the year following the index fracture.

Results

Among 273,330 individuals with fracture, 11,885 (4.3 %) sustained a second hip, shoulder or wrist fracture within one year. Hip fracture was most common, regardless of the index fracture type. Comparing adjusted second fracture risks across index fracture types reveals that the magnitude of second fracture risk within each age-comorbidity group is similar regardless of the index fracture. Men and women face similar risks with frequently overlapping confidence intervals, except among women aged 85 years or older who are at greater risk.

Conclusions

Regardless of index fracture type, second fractures are common in the year following hip, shoulder or wrist fracture. Secondary fracture prevention strategies that take a population perspective should be informed by these estimates which take competing mortality risks into account.
Appendix
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Literature
1.
Dennison E, Cole Z, Cooper C (2005) Diagnosis and epidemiology of osteoporosis. Curr Opin Rheumatol 17(4):456–461CrossRefPubMed
2.
Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359(9321):1929–1936CrossRefPubMed
3.
Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMed
4.
Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res Off J Am Soc Bone Miner Res 15(4):721–739CrossRef
5.
Robinson CM, Royds M, Abraham A et al (2002) Refractures in patients at least forty-five years old. a prospective analysis of twenty-two thousand and sixty patients. J Bone Joint Surg Am Vol 84-A(9):1528–1533CrossRef
6.
Cooper C, Atkinson EJ, O’Fallon WM et al (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res Off J Am Soc Bone Miner Res 7(2):221–227CrossRef
7.
Radley DC, Gottlieb DJ, Fisher ES et al (2008) Comorbidity risk-adjustment strategies are comparable among persons with hip fracture. J Clin Epidemiol 61(6):580–587CrossRefPubMedPubMedCentral
8.
Romano PS, Roos LL, Jollis JG (1993) Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: differing perspectives. J Clin Epidemiol 46(10):1075–1079, discussion 81-90CrossRefPubMed
9.
Eisman JA, Bogoch ER, Dell R et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res Off J Am Soc Bone Miner Res 27(10):2039–2046CrossRef
10.
11.
12.
Lee YK, Ha YC, Yoon BH et al (2013) Incidence of second hip fracture and compliant use of bisphosphonate. Osteoporos Int: J Established Result Cooperation Between Eur Foundation Osteoporos Nat Osteoporos Foundation USA 24(7):2099–2104CrossRef
13.
Melton LJ 3rd, Kearns AE, Atkinson EJ et al (2009) Secular trends in hip fracture incidence and recurrence. Osteoporos Int: J Established Result Cooperation Between Eur Foundation Osteoporos Nat Osteoporos Foundation USA 20(5):687–694CrossRef
14.
Melton LJ 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int: J Established Result Cooperation Between Eur Foundation Osteoporos Nat Osteoporos Foundation USA 9(1):29–37CrossRef
15.
16.
Gaines JM, Marx KA, Caudill J et al (2010) Older men’s knowledge of osteoporosis and the prevalence of risk factors. J Clin Densitometry: Off J Int Soc Clin Densitometry 13(2):204–209CrossRef
17.
Kiebzak GM, Beinart GA, Perser K et al (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162(19):2217–2222CrossRefPubMed
Metadata
Title
Second fractures among older adults in the year following hip, shoulder, or wrist fracture
Authors
J. P. W. Bynum
J.-E. Bell
R. V. Cantu
Q. Wang
C. M. McDonough
D. Carmichael
T. D. Tosteson
A. N. A. Tosteson
Publication date
01-07-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 7/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3542-6

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