Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective
Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective
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DOI：
10.1007/s00198-014-2875-2
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发表时间：
2015-02-01
影响因子：
4
通讯作者：
Vestergaard, P.
中科院分区：
文献类型：
--
作者：
Hansen, L.;Petersen, K. D.;Vestergaard, P.
50岁以后的骨折在丹麦很常见，其中许多骨折可能是骨质疏松。这项研究调查了2001至2011年间10年间所有骨折及后续骨折的发生率。继发骨折的发生率很高，尤其是髋部骨折。这项研究的目的是检查已经患有骨折的患者在10年内继发骨折的模式和死亡率。该研究被设计为一项全国性的登记随访研究。如果患者在2001年1月1日至2001年12月31日期间被诊断为指数性骨折(ICD-10代码：S22.x、S32.x、S42.x、S52.x、S62.x、S72.x、S82.x、S92.x、T02.x、T08.x、T10.x和T12.x)，并且在骨折时年龄超过50岁。从2002年1月1日至2011年12月31日对这些患者进行了未来骨折的调查。在这项研究中，我们证明了骨折(尤其是髋部骨折)患者有很高的再骨折风险，尤其是髋部骨折。其他骨折，通常不被认为是骨质疏松性骨折，如小腿，在指数性骨折后的10年内经常被观察到。在10年的随访期内，所有再发骨折的累积发生率(CIP)都很高(9-46%)。随后的髋部骨折，不考虑指征骨折，在整个研究期间有最高的CIP，范围在9%到40%之间。附件骨折后通常是复发性骨折，或在同一肢体的更近端继发骨折，即前臂骨折后是肱骨骨折。这些结果以前没有被证明到这种程度，而且据我们所知，以前的研究没有估计过任何非髋部骨折10年后的累积骨折发生率。患有骨折(尤其是髋部骨折)的患者继发骨折的发生率很高。在许多患者中，50岁以后的骨折可以被认为是未来骨折风险增加的早期预警。
Fractures after the age of 50 are frequently observed in Denmark, and many of these may be osteoporotic. This study examined the incidence of all and subsequent fractures in a 10-year period from 2001 to 2011. The incidence of subsequent fractures was high, especially following hip fracture.The purpose of this study is to examine patterns of subsequent fractures and mortality rates over a 10-year period in patients already suffering from fracture.The study was designed as a nationwide, register-based follow-up study. Patients were included if diagnosed with an index fracture (ICD-10 codes: S22.x, S32.x, S42.x, S52.x, S62.x, S72.x, S82.x, S92.x, T02.x, T08.x, T10.x and T12.x) between January 1st, 2001 and December 31st, 2001 and if older than 50 years at time of fracture. The patients were investigated for future subsequent fractures from January 1st, 2002 to December 31st, 2011.In this study, we demonstrated that patients with fractures (especially hip fractures) have a high risk of subsequent fractures, especially hip fracture. Other fractures, which are not commonly considered as osteoporotic fractures, such as lower leg, were frequently observed in the 10 years following index fracture. The cumulative incidence proportion (CIP) of subsequent fractures during the 10-year follow-up period was high for all recurrent fractures (9-46 %). Subsequent hip fracture, regardless of index fracture, had the highest CIP across the study period, ranging from 9 to 40 %. Appendicular fractures were often followed by a recurrent fracture, or subsequent fractures at a more proximal location in the same limb, i.e. forearm fractures were followed by humerus fractures. These results have not been previously demonstrated to this extent, and according to our knowledge, no previous studies have estimated cumulative 10-year subsequent fracture incidences for any non-hip fractures.Patients suffering a fracture (and especially a hip fracture) have a high incidence of subsequent fracture. Fractures after the age of 50 may be considered an early warning of increased risk for future fractures in many patients.