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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

The role of the combination of bone and fall related risk factors on short-term subsequent fracture risk and mortality

Authors: Kirsten MB Huntjens, Tineke ACM van Geel, Svenhjalmar van Helden, Joop van den Bergh, Paul Willems, Bjorn Winkens, Piet P Geusens, Peter RG Brink

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

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Abstract

Background

We analysed whether a combination of bone- and fall-related risk factors (RFs) in addition to a recent non-vertebral fracture (NVF) contributed to subsequent NVF risk and mortality during 2-years in patients who were offered fall and fracture prevention according to Dutch fracture- and fall-prevention guidelines.

Methods

834 consecutive patients aged ≥50 years with a recent NVF who were included. We compared subgroups of patients according to the presence of bone RFs and/or fall RFs (group 1: only bone RFs; group 2: combination of bone and fall RFs; group 3: only fall RFs; group 4: no additional RFs). Univariable and multivariable Cox regression analyses were performed adjusted for age, sex and baseline fracture location (major or minor).

Results

57 (6.8%) had a subsequent NVF and 29 (3.5%) died within 2-years. Univariable Cox regression analysis showed that patients with the combination of bone and fall RFs had a 99% higher risk in subsequent fracture risk compared to all others (Hazard Ratio (HR) 1.99; 95% Confidence Interval (CI) 1.18-3.36) Multivariable analyses this was borderline not significant (HR 1.70; 95% CI: 0.99-2.93). No significant differences in mortality were found between the groups.

Conclusion

Evaluation of fall RFs contributes to identifying patients with bone RFs at highest immediate risk of subsequent NVF in spite of guideline-based treatment. It should be further studied whether earlier and immediate prevention following a NVF can decrease fracture risk in patients with a combination of bone and fall RFs.
Appendix
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Metadata
Title
The role of the combination of bone and fall related risk factors on short-term subsequent fracture risk and mortality
Authors
Kirsten MB Huntjens
Tineke ACM van Geel
Svenhjalmar van Helden
Joop van den Bergh
Paul Willems
Bjorn Winkens
Piet P Geusens
Peter RG Brink
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-121

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