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Incidence and risk factors for a second hip fracture in elderly women. The Study of Osteoporotic Fractures

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Abstract

Women with hip fracture have an increased risk of second hip fracture but other risk factors for a second hip fracture have not been established. We sought to determine the incidence and risk factors for second hip fracture, in a prospective cohort study of community-dwelling postmenopausal women over 65 years: the Study of Osteoporotic Fractures. From a cohort of 9,704 women, 632 women with a documented first hip fracture during the study were followed up until a second hip fracture or the end of follow-up. Clinical risk factors and bone mineral density were assessed at the beginning of the study. Fifty-three second hip fractures were validated by radiographs. Women with hip fracture had a 2.3% per year risk of second hip fracture. Women who walked for exercise at baseline were less likely to sustain a second hip fracture with a relative risk (RR) of 0.5 [0.3–0.9], as were those who had normal depth perception (RR=0.5 [0.3–0.9]). Women who lost weight since age 25 years had an increased risk of second incident hip fracture (RR = 2.7 [1.6–4.6]), as did those who had a low calcaneal bone mineral density (RR=1.5 [1.1–2.0] per standard deviation decrease in bone mineral density). Current use of estrogen replacement therapy at baseline was protective (RR=0.5 [0.3–0.9]) up to 2 years of follow-up. We conclude that community-dwelling women with a first hip fracture have a high risk of second hip fracture, and risk factors for this second fracture are similar to those of first hip fracture.

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Acknowledgements

The Study of Osteoporotic Fractures has been funded by grants from the Public Health Service (1 RO1-AG05407, 1 RO1-AR35582, 5 RO1-AG05394, 1 RO1-AM35584, and 1 RO1-AR35583).

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Authors and Affiliations

  1. Prevention Sciences Group, University of California at San Francisco, California, USA

    R. D. Chapurlat, D. C. Bauer, M. Nevitt, K. Stone & S. R. Cummings

  2. Department of Rheumatology and Bone Diseases, Pavillon F, Hospital E Herriot, 5 Place d'Arsonval, 69437 , Lyon cedex 03, France

    R. D. Chapurlat

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  1. R. D. Chapurlat
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  2. D. C. Bauer
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  3. M. Nevitt
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  4. K. Stone
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  5. S. R. Cummings
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Correspondence to R. D. Chapurlat.

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Chapurlat, R.D., Bauer, D.C., Nevitt, M. et al. Incidence and risk factors for a second hip fracture in elderly women. The Study of Osteoporotic Fractures. Osteoporos Int 14, 130–136 (2003). https://doi.org/10.1007/s00198-002-1327-6

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  • DOI: https://doi.org/10.1007/s00198-002-1327-6

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