Risk of imminent fracture following a previous fracture in a Swedish database study
Risk of imminent fracture following a previous fracture in a Swedish database study
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DOI：
10.1007/s00198-019-04852-8
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发表时间：
2019-03-01
影响因子：
4
通讯作者：
Toth, E.
中科院分区：
文献类型：
--
作者：
Banefelt, J.;Akesson, K. E.;Toth, E.
本研究调查了50岁及以上女性首次骨折后1 - 2年内发生骨折的风险，并评估了与后续骨折风险相关的独立因素。该研究强调了骨折后快速干预以防止进一步骨折的必要性。本研究旨在确定首次骨折后1 - 2年内发生后续骨折的风险，并评估与后续骨折相关的独立因素。方法回顾性、观察性队列研究从瑞典国家登记的50岁女性脆性骨折患者中选取。计算指数骨折时的临床/人口学特征以及指数骨折后12个月和24个月的累计骨折发生率。采用多元回归分析确定后续骨折的危险因素。结果共纳入女性24212108例（平均[SD] 74[12.5]岁）。12个月时的累计骨折发生率为7.1%(95%可信区间[CI]， 6.9-7.2)， 24个月时为12.0% （95% CI, 11.8-12.1）。随后骨折的发生率在第一个月最高（类似于每1000患者-年15例骨折），并在4至24个月保持稳定（类似于每1000患者-年5例骨折）。较高的年龄是即将发生后续骨折的独立危险因素(在24个月时，亚分布风险比[HR]， 3.07
The SummaryThis study examined the imminent risk of a future fracture within 1 and 2years following a first fracture in women aged 50years and older and assessed independent factors associated with risk of subsequent fractures. The study highlights the need to intervene rapidly after a fracture to prevent further fractures.IntroductionThis study aims to determine the imminent risk of subsequent fractures within 1 and 2years following a first fracture and to assess independent factors associated with subsequent fractures.MethodsRetrospective, observational cohort study of women aged 50years with a fragility fracture was identified from Swedish national registers. Clinical/demographic characteristics at the time of index fracture and cumulative fracture incidences up to 12 and 24months following index fracture were calculated. Risk factors for subsequent fracture were identified using multivariate regression analysis.ResultsTwo hundred forty-two thousand one hundred eight women (mean [SD] age 74 [12.5] years) were included. The cumulative subsequent fracture incidence at 12months was 7.1% (95% confidence interval [CI], 6.9-7.2) and at 24months was 12.0% (95% CI, 11.8-12.1). The rate of subsequent fractures was highest in the first month (similar to 15 fractures per 1000 patient-years) and remained steady between 4 and 24months (similar to 5 fractures/1000 patient-years). Higher age was an independent risk factor for imminent subsequent fractures (at 24months, sub-distribution hazard ratio [HR], 3.07; p