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Incidence of subsequent fractures in the UK between 1990 and 2012 among individuals 50 years or older

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Abstract

Summary

We studied the incidence of subsequent fractures in persons of 50+ years from 1990 to 2012 and the relative risk (RR) of subsequent fractures after an index femur/hip fracture, stratified per 5-year age band. Patients suffering a fracture have a high incidence of a subsequent fracture; the RR of subsequent fracture after a femur/hip fracture ranged from 2 to 7.

Introduction

Recent information on the risk of subsequent fractures after a broad range of index fractures in the UK population is scarce. We therefore studied the rates of subsequent fractures of the femur/hip, humerus, radius/ulna, vertebrae, rib, or pelvis after fractures at one of these sites from 1990 to 2012 in 3,156,347 UK men and women aged 50 years or over.

Methods

We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD). The incidence of subsequent fractures at a specific site was calculated by dividing the observed number of fractures by the number of person-years (py) at risk. The relative risk (RR) of subsequent fractures after a femur/hip fracture, by 5-year age band, was calculated by dividing the incidence of a specific subsequent fracture type by the incidence of first fractures at the same site in the same age group.

Results

The highest subsequent fracture incidence after a femur/hip fracture was for humerus fracture in men (59.5/10.000 py) and radius/ulna fracture in women (117.2/10.000 py). After an index fracture of the radius/ulna, humerus fracture in men (59.3/10.000 py) and femur/hip fracture in women (82.4 per 10.000 py) were most frequent. The RR of fractures after a femur/hip fracture ranged from 2 to 7 and were highest in men and younger age groups.

Conclusion

Patients suffering a fracture have a high incidence of a subsequent fracture. Our findings demonstrate the importance of fracture prevention in patients with a history of a fracture by adequate medical diagnosis and treatment.

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Funding

TvS and NCH are joint senior author. The work was supported by a grant from the National Osteoporosis Society. This work was further supported by the Medical Research Council, British Heart Foundation, Arthritis Research UK, International Osteoporosis Foundation, National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, and NIHR Oxford Biomedical Research Centre, University of Oxford.

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Authors and Affiliations

  1. Department of Internal Medicine, VieCuri Medical Centre, PO Box 1926, 5900 BX, Venlo, The Netherlands

    R. Y. van der Velde, C. E. Wyers & J. P. W. van den Bergh

  2. Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands

    R. Y. van der Velde, C. E. Wyers & J. P. W. van den Bergh

  3. Department of Internal Medicine, Subdivision Rheumatology, CAPHRI, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands

    P. P. M. M. Geusens

  4. Biomedical Research Centre, Hasselt University, Agoralaan – gebouw D, 3590, Diepenbeek, Belgium

    P. P. M. M. Geusens & J. P. W. van den Bergh

  5. Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands

    F. de Vries

  6. Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

    F. de Vries & T. P. van de Staa

  7. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    C. Cooper & N. C. Harvey

  8. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK

    C. Cooper & N. C. Harvey

  9. NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK

    C. Cooper & T. P. van de Staa

  10. Health eResearch Centre, University of Manchester, Manchester, UK

    T. P. van de Staa

Authors
  1. R. Y. van der Velde
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  2. C. E. Wyers
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  3. P. P. M. M. Geusens
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  4. J. P. W. van den Bergh
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  5. F. de Vries
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  6. C. Cooper
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  7. T. P. van de Staa
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  8. N. C. Harvey
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Corresponding author

Correspondence to C. Cooper.

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Additional information

T. P. van de Staa and N. C. Harvey are joint senior author

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van der Velde, R.Y., Wyers, C.E., Geusens, P.P.M.M. et al. Incidence of subsequent fractures in the UK between 1990 and 2012 among individuals 50 years or older. Osteoporos Int 29, 2469–2475 (2018). https://doi.org/10.1007/s00198-018-4636-0

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