Fracture risk following an osteoporotic fracture

被引:6
作者
Johnell O. [1 ]
Kanis J.A. [2 ]
Odén A.
Sernbo I. [1 ]
Redlund-Johnell I. [1 ]
Petterson C. [1 ]
De Laet C. [3 ]
Jönsson B. [4 ]
机构
[1] Department of Orthopaedics, Malmö University Hospital, Malmö
[2] WHO Collaborat. Ctr. Metab. Bone D., Univ. of Sheffield Medical School, Sheffield
[3] Institute for Public Health, University Medical Center, Rotterdam
[4] Department of Economics, Stockholm School of Economics, Stockholm
关键词
Forearm; Fracture risk; Hip; Osteoporosis; Spine;
D O I
10.1007/s00198-003-1514-0
中图分类号
学科分类号
摘要
The aim of this study was to examine the pattern of fracture risk following a prior fracture at the spine, shoulder or hip. We studied 1918 patients with fractures at these sites identified from the Department of Radiology in Malmo who were followed for 5 years. Poisson regression was used to compute fracture rates immediately after the initial fracture and at 5 years thereafter in men and women aged 60 or 80 years. Immediate fracture risk was higher than that of the general population, more markedly so at the age of 60 than at 80 years. At the age of 60 years, the risk of hip, forearm and spine fractures were significantly increased following a prior spine, hip or shoulder fracture in men. A similar pattern was seen in women, except that the increase in risk of forearm fracture following a spine or hip fracture was not statistically significant. The incidence of further fractures at the shoulder, spine or hip fell with time after the first fracture, a fall that was significant for all fractures after a shoulder fracture, hip fracture after a spine fracture, and hip and spine fractures after a hip fracture. We conclude that the risk of a subsequent fracture immediately after an osteoporotic fracture is highest immediately after the event. This provides a rationale for very early intervention immediately after fractures to avoid recurrent fractures.
引用
收藏
页码:175 / 179
页数:4
相关论文
共 17 条
[1]  
Klotzbuecher C.M., Ross P.D., Landsman P.B., Abbot III T.A., Berger M., Patients with prior fractures have an increased risk of future fractures: A summary of the literature and statistical synthesis, J Bone Miner Res, 15, pp. 721-739, (2000)
[2]  
Johnell O., Oden A., Caulin F., Kanis J.A., Acute and long-term increase in fracture risk after hospitalization for vertebral fracture, Osteoporos Int, 12, pp. 207-214, (2001)
[3]  
Lindsay R., Silverman S.L., Cooper C., Hanley D.A., Barton I., Broy S.B., Licata A., Benhamou L., Geusens P., Flowers K., Stracke H., Seeman E., Risk for new vertebral fracture in the year following a fracture, JAMA, 285, pp. 320-323, (2001)
[4]  
Kanis J.A., Johnell O., Oden A., Sernbo I., Redlund-Johnell I., Dawson A., De Laet C., Jonsson B., Long-term risk of osteoporotic fracture in Malmö, Osteoporos Int, 11, pp. 669-674, (2000)
[5]  
Jonsson B., Gardsell P., Johnell O., Redlund-Johnell I., Sernbo I., Remembering fractures: Fracture registration and proband recall in Southern Sweden, J Epidemiol Comm Health, 48, pp. 489-490, (1994)
[6]  
Van Staa T.P., Leufkens H.G.M., Coopewr C., Does a fracture at one site predict later fractures at other sites? A British cohort study, Osteoporos Int, 13, pp. 624-629, (2002)
[7]  
Hasserius R., Karlsson M.K., Nilsson B.E., Redlund-Johnell I., Johnell O., Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: A 10 year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study, Osteoporos Int, 14, pp. 61-68, (2003)
[8]  
Castel H., Bonneth D.Y., Sherf M., Liel Y., Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low impact fractures, Osteoporos Int, 12, pp. 559-564, (2001)
[9]  
Torgerson D.J., Dolan P., Prescribing by general practitioners after an osteoporotic fracture, Ann Rheum Dis, 57, pp. 378-379, (1998)
[10]  
Black D.M., Cummings S.R., Karpf D.B., Et al., Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fracture, Lancet, 348, pp. 1535-1541, (1996)