Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
Hip fracture
Major osteoporotic fracture
Meta-analysis
Osteoporotic fracture
Prior fracture
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
22
03
2023
accepted:
22
07
2023
medline:
16
11
2023
pubmed:
11
8
2023
entrez:
11
8
2023
Statut:
ppublish
Résumé
A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX. The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD). We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients. A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination. A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
Identifiants
pubmed: 37566158
doi: 10.1007/s00198-023-06870-z
pii: 10.1007/s00198-023-06870-z
pmc: PMC7615305
mid: EMS187236
doi:
Types de publication
Meta-Analysis
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2027-2045Subventions
Organisme : NHLBI NIH HHS
ID : 75N92021D00002
Pays : United States
Organisme : Medical Research Council
ID : MC_UU_00006/1
Pays : United Kingdom
Organisme : WHI NIH HHS
ID : 75N92021D00005
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92021D00001
Pays : United States
Organisme : WHI NIH HHS
ID : 75N92021D00003
Pays : United States
Organisme : Medical Research Council
ID : MC_PC_21036
Pays : United Kingdom
Organisme : WHI NIH HHS
ID : 75N92021D00004
Pays : United States
Informations de copyright
© 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
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