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

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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 languageEnglish
Article number121
Number of pages8
JournalBMC Musculoskeletal Disorders
Publication statusPublished - 4 Apr 2013


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