Re-fracture and correlated risk factors in patients with osteoporotic vertebral fractures
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Re-fracture risk is higher following osteoporotic fracture. However, there is no accurately reported rate of re-fracture incidence in southwest China. The purpose of this study was to describe the osteoporotic vertebral fracture (OVF) survival for re-fracture state and analyze the risk of re-fracture. This historical cohort study was conducted in four hospitals in southwest China. Patients aged ≥ 50 years (n = 586) with OVF who were supposed to receive anti-osteoporosis drugs after the fracture were included (2012–2017). Telephone follow-up and referring case files were used to estimate the survival for re-fracture and identify the determinants of re-fracture. A total of 555 patients completed the follow-up investigation. Overall, 285 patients experienced a re-fracture, and the longest follow-up investigation time was 72 months. The survival rates for re-fracture at 12 months, 24 months, 36 months, and 48 months were 82.0%, 71.5%, 61.7%, and 34.0%, respectively. The factors correlated with re-fracture hazard were advanced age [hazard ratio (HR) = 1.996], being female (HR = 1.342), smoking (HR = 1.435), history of hypertension (HR = 1.219) and diabetes (HR = 3.271), and persistence of taking anti-osteoporosis drugs after fracture [0–3 months, 4–6 months, 7–12 months, and more than 12 months (HR = 0.703)]. OVF patients with advanced age, who were female, smoked, had fracture with hypertension or diabetes, and who complied poorly with anti-osteoporosis drug treatment presented higher prevalence of re-fracture and low anti-osteoporosis adherence in southwest China. The management of anti-osteoporosis after fracture is necessary in this area.
KeywordsOsteoporotic vertebral fracture Re-fracture Osteoporosis Anti-osteoporosis
This research was supported by the Fuxing Nursing Scientific Research Fund of Fudan University (FNF201708) and the National Natural Science Foundation of China (815602390). The research group thanks the patients who participated in this study. In addition, we thank Zhang Xianyan, Huang Chengjing, He Shiyuan, and Lv Shouqiang of Youjiang Medical University for Nationalities, who assisted with the study.
Compliance with ethical standards
Conflict of interest
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject(s) of this article.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments and/or comparable ethical standards.
Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.
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