Osteoporosis International

, Volume 18, Issue 8, pp 1091–1100

Age and drug therapy are key prognostic factors for first clinical fracture in patients with primary osteoporosis

  • O. Gajic-Veljanoski
  • R. J. Sebaldt
  • A. M. Davis
  • D. Tritchler
  • G. Tomlinson
  • A. Petrie
  • J. D. Adachi
  • A. M. Cheung
Original Article

DOI: 10.1007/s00198-007-0340-1

Cite this article as:
Gajic-Veljanoski, O., Sebaldt, R.J., Davis, A.M. et al. Osteoporos Int (2007) 18: 1091. doi:10.1007/s00198-007-0340-1

Abstract

Summary

We evaluated the characteristics of 1,142 women and men who attended Canadian osteoporosis clinics and had T-score ≤ −2.0 and no prior fractures to determine the predictors of first clinical fracture. Greater age and failure to start osteoporosis drug treatment increased the risk of first clinical fracture.

Introduction

Although risk factors for osteoporotic fractures are well-known, it is unclear which factors predict poor prognosis in patients with primary osteoporosis. The purpose of this study was to determine prognostic factors for first clinical fracture in patients with T-score ≤ −2.0 and no previous clinical fracture.

Methods

We examined prospectively collected data from 1,142 patients aged 40 and over in the Canadian Database of Osteoporosis and Osteopenia. We used prognosis methodology and performed survival analysis to determine factors that increase the risk of first clinical fracture.

Results

Our inception cohort (mean age = 60.6 years, 91% females) had a cumulative fracture incidence of 5.1% (incidence rate: 2.53/100 person-years). Age and osteoporosis drug use predicted incident clinical fractures in multivariable regression analyses. The risk of first fracture increased by 3% per year. Failing to initiate osteoporosis treatment increased fracture risk by 2.4 times. In addition, low physical activity, high body mass index and low T-scores were found to predict fracture risk in certain patient subgroups using tree-structured survival analysis. These findings were robust and did not change with most sensitivity analyses.

Conclusion

Age and osteoporosis drug treatment are the main prognostic predictors of first clinical fracture in patients with T-score ≤ −2.0.

Keywords

AgeDrug therapy useFirst clinical fracturePrimary osteoporosisPrognostic factors

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • O. Gajic-Veljanoski
    • 1
    • 2
  • R. J. Sebaldt
    • 3
    • 4
  • A. M. Davis
    • 2
    • 5
  • D. Tritchler
    • 6
  • G. Tomlinson
    • 2
    • 6
  • A. Petrie
    • 3
  • J. D. Adachi
    • 3
    • 4
  • A. M. Cheung
    • 1
    • 2
    • 7
  1. 1.Osteoporosis ProgramUniversity Health NetworkTorontoCanada
  2. 2.Department of Health Policy Management and EvaluationUniversity of TorontoTorontoCanada
  3. 3.Department of MedicineMcMaster UniversityHamiltonCanada
  4. 4.St. Joseph’s HospitalMcMaster UniversityHamiltonCanada
  5. 5.Outcomes and Population Health, Toronto Western Research InstituteUniversity Health NetworkTorontoCanada
  6. 6.University Health NetworkTorontoCanada
  7. 7.TorontoCanada