Skip to main content

Advertisement

Log in

Clinical and biological parameters associated with fracture recurrence according to fracture liaison service dataset

  • Short Communication
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

This study describes the characteristics of 337 patients seen by the fracture liaison service of the Amiens University Hospital for at least two osteoporotic fractures between 2009 and 2019. Results showed that recurrent fracture occurs rapidly after the index fracture. Rheumatological and therapeutic managements are not sufficient, mainly because of cognitive disorders or patients’ refusal.

Purpose

The aim of this study was to describe the characteristics of patients taken in charge by a fracture liaison service and sustaining a recurrent osteoporotic fracture.

Methods

This was a retrospective and monocentric study based on the dataset of patients included in the FLS of the Department of Rheumatology of the Amiens University Hospital. To be included in the study cohort, patients must have had at least two consecutive osteoporotic fractures between January 2009 and December 2019.

Results

Three hundred thirty-seven patients were included. The mean age at index fracture was 77.3 ± 12.5 years. Eighty-four percent of the patients were women. 89.3% of the patients had a Charlson comorbidity index between 1 and 4. Nearly half of the patients had cognitive disorders. Femoral neck was the most frequent site for both index and recurrent fractures. Thirty-seven percent of patients benefited from a consultation in Rheumatology after their index fracture. The main reasons for the lack of follow-up were cognitive disorders and patient rejection.

Conclusion

Our study showed that recurrent fracture occurs rapidly after the index fracture and that rheumatological and therapeutic managements are not sufficient, mainly because of cognitive disorders or patients’ refusal impairing the patients to benefit from specialized management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. van Geel TA, van Helden S, Geusens PP, Winkens B, Dinant GJ (2009) Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis 68(1):99–102. https://doi.org/10.1136/ard.2008.092775

    Article  PubMed  Google Scholar 

  2. Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E et al (2017) Imminent risk of fracture after fracture. Osteoporos Int J 28(3):775–780

    Article  CAS  Google Scholar 

  3. Banefelt J, Åkesson KE, Spångéus A, Ljunggren O, Karlsson L, Ström O et al (2019) Risk of imminent fracture following a previous fracture in a Swedish database study. Osteoporos Int 30(3):601–609

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kanis JA, Johansson H, Odén A, Harvey NC, Gudnason V, Sanders KM et al (2018) Characteristics of recurrent fractures. Osteoporos Int 29(8):1747–1757

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD (2006) Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum 35(5):293–305. https://doi.org/10.1016/j.semarthrit.2005.11.001

    Article  CAS  PubMed  Google Scholar 

  6. Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R et al (2018) Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum 85(5):428–440

    Article  Google Scholar 

  7. Roux C, Thomas T, Paccou J, Bizouard G, Crochard A, Toth E et al (2021) Refracture and mortality following hospitalization for severe osteoporotic fractures: The fractos study. JBMR Plus 5(7). https://doi.org/10.1002/jbm4.10507

  8. Bynum JPW, Bell JE, Cantu RV, Wang Q, McDonough CM, Carmichael D et al (2016) Second fractures among older adults in the year following hip, shoulder, or wrist fracture. Osteoporos Int 27(7):2207–2215

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Ganda K, Schaffer A, Seibel MJ (2015) Predictors of re-fracture amongst patients managed within a secondary fracture prevention program: a 7-year prospective study. Osteoporos Int 26:543–551. https://doi.org/10.1007/s00198-014-2880-5

    Article  CAS  PubMed  Google Scholar 

  10. Eekman DA, van Helden SH, Huisman AM, Verhaar HJJ, Bultink IEM, Geusens PP et al (2014) Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporos Int 25(2):701–709

    Article  CAS  PubMed  Google Scholar 

  11. Solomon DH, Johnston SS, Boytsov NN, McMorrow D, Lane JM, Krohn KD (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res 29(9):1929–1937

    Article  PubMed  Google Scholar 

  12. Briançon D, de Gaudemar JB, Forestier R (2004) Management of osteoporosis in women with peripheral osteoporotic fractures after 50 years of age: a study of practices. Jt. Bone Spine 71(2):128–130. https://doi.org/10.1016/S1297-319X(03)00060-5

    Article  Google Scholar 

  13. Malochet-Guinamand S, Chalard N, Billault C, Breuil N, Ristori JM, Schmidt J (2005) Osteoporosis treatment in postmenopausal women after peripheral fractures: impact of information to general practitioners. Jt. Bone Spine 72(6):562–566

    Article  Google Scholar 

  14. Dehamchia-Rehailia N, Ursu D, Henry-Desailly I, Fardellone P, Paccou J (2014) Secondary prevention of osteoporotic fractures: evaluation of the Amiens University Hospital’s fracture liaison service between January 2010 and December 2011. Osteoporos Int 25(10):2409–2416. https://doi.org/10.1007/s00198-014-2774-6

    Article  CAS  PubMed  Google Scholar 

  15. Kannegaard PN, van der Mark S, Eiken P, Abrahamsen BO (2010) Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age ageing 39(2):203–209

    Article  PubMed  Google Scholar 

  16. McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14(12):1028–1034

    Article  PubMed  Google Scholar 

  17. Huntjens KMB, Van Geel TACM, Blonk MC, Hegeman JH, Van der Elst M, Willems P, Van Helden SH (2011) Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands. Osteoporosis Int 22:2129–2135

    Article  CAS  Google Scholar 

  18. Prieto-Alhambra D, Judge A, Arden NK, Cooper C, Lyles KW, Javaid MK (2014) Fracture prevention in patients with cognitive impairment presenting with a hip fracture: secondary analysis of data from the HORIZON Recurrent Fracture Trial. Osteoporos Int 25(1):77–83

    Article  CAS  PubMed  Google Scholar 

  19. Greenspan S, Nace D, Perera S, Ferchak M, Fiorito G, Medich D et al (2012) Lessons learned from an osteoporosis clinical trial in frail long-term care residents. Clin Trials 9(2):247–256

    Article  PubMed  Google Scholar 

  20. Gehlbach S, Saag KG, Adachi JD, Hooven FH, Flahive J, Boonen S et al (2012) Previous fractures at multiple sites increase the risk for subsequent fractures: The global longitudinal study of osteoporosis in women. J Bone Miner Res 27(3):645–653

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marie Doussiere.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Doussiere, M., Jesson, C., Diep, L. et al. Clinical and biological parameters associated with fracture recurrence according to fracture liaison service dataset. Osteoporos Int 34, 1977–1982 (2023). https://doi.org/10.1007/s00198-023-06868-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-023-06868-7

Keywords

Navigation