Osteoporotic fractures and subsequent fractures: imminent fracture risk from an analysis of German real-world claims data.
Osteoporotic fractures and subsequent fractures: imminent fracture risk from an analysis of German real-world claims data.
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骨质疏松性骨折和随后的骨折：来自德国真实世界索赔数据分析的迫在眉睫的骨折风险。
DOI：
10.1007/s00404-021-06123-6
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发表时间：
2021-09
影响因子：
2.6
通讯作者：
Glüer CC
中科院分区：
文献类型：
--
作者：
Hadji P;Schweikert B;Kloppmann E;Gille P;Joeres L;Toth E;Möckel L;Glüer CC
在骨质疏松症中，先前骨折是后续骨折的强有力预测因素。本研究旨在评估德国骨质疏松症患者初次骨折后继发骨折的紧迫风险，并确定与继发骨折风险独立相关的临床和人口统计学特征。在这项使用德国真实世界索赔数据的回顾性、观察性队列研究中，纳入了2010年至2014年期间发生初始（“索引”）髋关节/股骨、椎骨、前臂/腕关节/手或肩关节/上臂骨折的年龄≥ 50岁的骨质疏松症男性和女性患者。分析了1年随访期间后续骨折的发生率和时间。通过多元回归分析确定了继发骨折的独立危险因素。共纳入18，354例患者（平均年龄：77岁;标准差：9.8）。其中，2918例（15.9%）在1年随访期间发生了后续骨折。指数椎骨骨折（18.0%）后后续骨折的发生率高于指数前臂/手腕/手骨折（14.1%）或指数髋部/股骨骨折（12.1%）后的发生率。老年患者随后1年的骨折发生率通常较高。指数骨折类型、年龄、癫痫/抗癫痫药使用和心力衰竭均与随后的骨折风险独立相关。德国的骨质疏松症患者在初次骨折后的第一年内有发生后续骨折的紧迫风险。骨折后应立即进行针对性治疗，以降低进一步骨折的风险，特别是在存在特定风险因素的情况下，如老年或指数椎骨骨折。在线版本包含补充材料，可通过10.1007/s 00404 -021-06123-6获得。
In osteoporosis, prior fracture is a strong predictor of subsequent fracture. This study aimed to assess the imminent risk of subsequent fracture following an initial fracture in osteoporosis patients in Germany, and to identify clinical and demographic characteristics that are independently associated with subsequent fracture risk. In this retrospective, observational cohort study using German real-world claims data, male and female patients aged ≥ 50 years with osteoporosis who experienced an initial (“index”) hip/femur, vertebral, forearm/wrist/hand or shoulder/upper arm fracture between 2010 and 2014 were included. The incidence and timing of subsequent fractures during a 1-year follow-up period were analyzed. Independent risk factors for subsequent fracture were identified by multivariate regression analysis. A total of 18,354 patients (mean age: 77 years; standard deviation: 9.8) were included. Of these, 2918 (15.9%) suffered a subsequent fracture during the 1-year follow-up period. The incidence of subsequent fracture was higher following an index vertebral fracture (18.0%) than after an index forearm/wrist/hand fracture (14.1%) or index hip/femur fracture (12.1%). Subsequent 1-year fracture incidence was generally higher in older patients. Index fracture type, age, epilepsy/use of antiepileptics, and heart failure were all independently associated with subsequent fracture risk. Osteoporosis patients in Germany are at imminent risk of subsequent fracture during the first year following an initial fracture. They should be targeted for immediate post-fracture treatment to reduce the risk of further fractures, especially in the presence of specific risk factors such as old age or index vertebral fracture. The online version contains supplementary material available at 10.1007/s00404-021-06123-6.
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影响因子：
3
作者：
Ertl, Julia;Hapfelmeier, Jana;Strzelczyk, Adam
通讯作者：
Strzelczyk, Adam
影响因子：
6.2
作者：
Burge, Russel;Dawson-Hughes, Bess;Tosteson, Anna
通讯作者：
Tosteson, Anna
影响因子：
4
作者：
Banefelt, J.;Akesson, K. E.;Toth, E.
通讯作者：
Toth, E.
影响因子：
0.6
作者：
Krasselt, Marco;Baerwald, Christoph
通讯作者：
Baerwald, Christoph
影响因子：
4
作者：
Hansen, L.;Petersen, K. D.;Vestergaard, P.
通讯作者：
Vestergaard, P.