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

K.M.B. Huntjens; T.A.C.M. van Geel; S. van Helden; J. van den Bergh; P. Willems; B. Winkens; P.P. Geusens; P.R.G. Brink

doi:10.1186/1471-2474-14-121

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

K.M.B. Huntjens^*, T.A.C.M. van Geel, S. van Helden, J. van den Bergh, P. Willems, B. Winkens, P.P. Geusens, P.R.G. Brink

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Article number	121
Number of pages	8
Journal	BMC Musculoskeletal Disorders
Volume	14
DOIs	https://doi.org/10.1186/1471-2474-14-121
Publication status	Published - 4 Apr 2013

Keywords

OSTEOPOROTIC FRACTURE
POSTMENOPAUSAL WOMEN
VERTEBRAL FRACTURES
MEN
IMPLEMENTATION
GUIDELINES

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Cite this

@article{e853f11089794aafb20351861a835b03,

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

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.",

keywords = "OSTEOPOROTIC FRACTURE, POSTMENOPAUSAL WOMEN, VERTEBRAL FRACTURES, MEN, IMPLEMENTATION, GUIDELINES",

author = "K.M.B. Huntjens and {van Geel}, T.A.C.M. and {van Helden}, S. and {van den Bergh}, J. and P. Willems and B. Winkens and P.P. Geusens and P.R.G. Brink",

year = "2013",

month = apr,

day = "4",

doi = "10.1186/1471-2474-14-121",

language = "English",

volume = "14",

journal = "BMC Musculoskeletal Disorders",

issn = "1471-2474",

publisher = "BioMed Central Ltd",

}

TY - JOUR

T1 - The role of the combination of bone and fall related risk factors on short-term subsequent fracture risk and mortality

AU - Huntjens, K.M.B.

AU - van Geel, T.A.C.M.

AU - van Helden, S.

AU - van den Bergh, J.

AU - Willems, P.

AU - Winkens, B.

AU - Geusens, P.P.

AU - Brink, P.R.G.

PY - 2013/4/4

Y1 - 2013/4/4

N2 - 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.

AB - 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.

KW - OSTEOPOROTIC FRACTURE

KW - POSTMENOPAUSAL WOMEN

KW - VERTEBRAL FRACTURES

KW - MEN

KW - IMPLEMENTATION

KW - GUIDELINES

U2 - 10.1186/1471-2474-14-121

DO - 10.1186/1471-2474-14-121

M3 - Article

C2 - 23557115

SN - 1471-2474

VL - 14

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

M1 - 121

ER -