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Risk factors for subsequent vertebral fractures following a previous hip fracture

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Abstract

Introduction

The purpose of our study was to evaluate the incidence and to identify risk factors of subsequent vertebral fractures after hip fractures, and to determine whether the subsequent vertebral fracture increases the mortality rate of elderly hip fracture patients.

Materials and methods

From January 2009 to July 2016, 1,554 patients were diagnosed as having a hip fracture and were treated surgically at our institution. Among them, 1121 patients age > 50 years at the time of injury and were followed up for 1 year or longer after the hip fracture surgery. In these patients, radiographs of the hip and spine were taken at each follow-up. We reviewed medical records and radiographs of these patients. Among the 1121 patients, 107 patients (9.5%) had subsequent vertebral fractures after the hip fracture during entire follow-up periods.

Results

In multivariable analysis, previous history of vertebral fracture [odds ratio (OR), 2.62; p < 0.001], medication possession rate (MPR) of osteoporosis treatment < 80% (OR, 1.92; p = 0.014), and a lower lumbar bone mineral density (BMD) (OR, 2.58; p = 0.001) appeared as risk factors for subsequent vertebral fractures.

Conclusion

However, the subsequent vertebral fractures did not affect the mortality after the hip fractures. Age ≥ 70 years [hazard ration (HR) 2.70; p = .039], body mass index < 18.5 kg/m2 (HR, 2.57; p =0 .048), and Charlson comorbidity index ≥ 2 (HR, 2.04; p =0.036) were risk factors of the death. Timely management is warranted to prevent subsequent vertebral fractures in hip fracture patients with risk factors.

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Funding

This study was funded by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea [grant number: HI18C0284].

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Gyeonggi-do 13620, Seongnam-si, South Korea

    Sang-Min Park, Sung Jun Go, Heesoo Han, Jung Wee Park, Young-Kyun Lee, Ho-Joong Kim, Jin S. Yeom & Kyung-Hoi Koo

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  1. Sang-Min Park
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Correspondence to Young-Kyun Lee.

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Our study protocol was approved by the institutional review board of our hospital (B-1907/552-101). The requirement for informed consent was waived by the review board due to the retrospective nature of the study.

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Park, SM., Go, S.J., Han, H. et al. Risk factors for subsequent vertebral fractures following a previous hip fracture. J Bone Miner Metab 39, 193–200 (2021). https://doi.org/10.1007/s00774-020-01133-x

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