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01-08-2019 | Ankle Fracture | Original Article

Five-year refracture rates of a province-wide fracture liaison service

Authors: R. Sujic, D.E. Beaton, M. Mamdani, S.M. Cadarette, J. Luo, S. Jaglal, J.E.M. Sale, R. Jain, E. Bogoch, the Ontario Osteoporosis Strategy Fracture Screening and Prevention Program Evaluation Team

Published in: Osteoporosis International | Issue 8/2019

Abstract

Summary

We examined the 5-year refracture rate of 6543 patients and found an overall rate of 9.7%. Adjusted analysis showed that presenting with multiple fractures was an indicator of a higher refracture risk; while presenting with an ankle fracture was associated with a lower refracture risk.

Introduction

To examine refractures among patients screened in a province-wide fracture liaison service (FLS).

Methods

We assessed the 5-year refracture rate of fragility fracture patients aged 50+ who were screened at 37 FLS fracture clinics in Ontario, Canada. Refracture was defined as a new hip, pelvis, spine, distal radius, or proximal humerus fracture. Kaplan-Meier curves and Cox proportional hazards model adjusting for age, sex, and index fracture type were used to examine refracture rates.

Results

The 5-year refracture rate of 6543 patients was 9.7%. Those presenting with multiple fractures at baseline (i.e., two or more fractures occurring simultaneously) had the highest refracture rate of 19.6%. As compared to the 50–65 age group, refracture risk increased monotonically with age group (66–70 years: HR = 1.3, CI 95%, 1.0–1.7; 71–80 years: HR = 1.7, CI 1.4–2.1; 81+ years: HR = 3.0, CI 2.4–3.7). Relative to distal radius, presenting with multiple fractures at screening was associated with a higher risk of refracture (HR = 2.3 CI 1.6–3.1), while presenting with an ankle fracture was associated with a lower risk of refracture (HR = 0.7 CI 0.6–0.9). Sex was not a statistically significant predictor of refracture risk in this cohort (HR = 1.2, CI 1.0–1.5).

Conclusions

One in ten patients in our cohort refractured within 5 years after baseline. Presenting with multiple fractures was an indicator of a higher refracture risk, while presenting with an ankle fracture was associated with a lower refracture risk. A more targeted FLS approach may be appropriate for patients at a higher refracture risk.

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Title: Five-year refracture rates of a province-wide fracture liaison service
Authors: R. Sujic
D.E. Beaton
M. Mamdani
S.M. Cadarette
J. Luo
S. Jaglal
J.E.M. Sale
R. Jain
E. Bogoch
the Ontario Osteoporosis Strategy Fracture Screening and Prevention Program Evaluation Team
Publication date: 01-08-2019
Publisher: Springer London
Keywords: Ankle Fracture
Refracture
Published in: Osteoporosis International / Issue 8/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-019-05017-3

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Springer Medicine

Five-year refracture rates of a province-wide fracture liaison service

Abstract

Summary

Introduction

Methods

Results

Conclusions

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Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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