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Erschienen in: Archives of Osteoporosis 1/2022

01.12.2022 | Original Article

Incidence of different types of subsequent fractures and related mortality in Taiwan

verfasst von: Jiun-Liang Chen, Ta-Wei Tai, Che-Yi Chou, Chieh-Ko Ku, Li-Nien Chien, Tsan-Wen Huang, Chao-Hsuin Tang

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2022

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Abstract

Summary

Hip fracture is the most common type of fracture to occur within 2 years after an initial fracture. Mortality risk increases when a subsequent fracture occurs. The occurrence of subsequent fracture is significantly higher in patients with hip fractures than others. Prevention of subsequent fracture is of paramount important.

Purpose

Osteoporotic fracture significantly increases risk of subsequent fracture. In this retrospective cohort study, we used the Taiwan National Health Insurance Database (NHIRD) to analyze data on fractures in a group at high risk of osteoporosis. We aimed to distinguish differences in subsequent fracture types and their relationship with mortality.

Methods

We enrolled patients aged ≥ 50 years old who were diagnosed with an initial fracture classified as hip, vertebral, upper end of the humerus, or wrist. Data from 2 years of follow-up were analyzed. Risks of subsequent fracture events and mortality were calculated by Kaplan–Meier estimation and assessed with Cox proportional hazards models.

Results

We included 375,836 patients from the 2011–2015 NHIRD. Patients with initial hip fracture had the highest incidence of subsequent fracture at both 1- and 2-year follow-up (7.0% and 10.9%). Subsequent fractures occurred mainly at the hip. Conversely, other patients had a higher proportion of subsequent vertebral fracture. Patients with subsequent fracture classified as hip, vertebral, and upper end of the humerus had significantly higher cumulative mortality rates than that of patients who had no subsequent fracture, with adjusted hazard ratios of 1.64 (95% CI = 1.57–1.71, p < 0.01), 1.06 (95% CI = 1.00–1.12, p = 0.04), 1.31 (95% CI = 1.17–1.46, p < 0.01), respectively.

Conclusion

Patients who experienced an initial hip fracture are at greatest risk of subsequent fracture, most commonly the hip. Occurrence of subsequent fractures was associated with an increased mortality risk. Thus, there is a need for early intervention following initial hip fractures.
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Metadaten
Titel
Incidence of different types of subsequent fractures and related mortality in Taiwan
verfasst von
Jiun-Liang Chen
Ta-Wei Tai
Che-Yi Chou
Chieh-Ko Ku
Li-Nien Chien
Tsan-Wen Huang
Chao-Hsuin Tang
Publikationsdatum
01.12.2022
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2022
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01098-6

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