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Epidemiological transition to mortality and re-fracture following an initial fracture


This study sought to redefine the concept of fracture risk that includes refracture and mortality. We analysed data obtained from 2046 women and 1205 men aged 60+ years, whose health status, including bone mineral density (BMD), has been monitored. During the 20-year follow-up period, among 632 women and 184 men with a first incident fracture, the risk of sustaining a second fracture was higher in women (36%, n=229) than in men (22%, n=41), but mortality risk was higher in men (41%, n=75) than in women (25%, n=156). Key predictors of subsequent fracture risk included advancing age (hazard ratio [HR] 1.17; 95%CI, 1.08-1.26) and low BMD (HR 1.41; 1.23-1.61). Predictors of mortality were male gender (HR 2.4; 1.79-3.21), advancing age (1.67; 1.53-1.83), and lower femoral neck BMD (1.16; 1.01-1.33). These results were incorporated into a prediction model to aid patient-doctor discussion about fracture vulnerability and treatment decisions.

Type Journal
ISBN 2050-084X (Electronic) 2050-084X (Linking)
Authors Ho-Le, T. P.; Tran, T. S.; Bliuc, D.; Pham, H. M.; Frost, S. A.; Center, J. R.; Eisman, J. A.; Nguyen, T. V.
Responsible Garvan Author (missing name)
Publisher Name eLife
Published Date 2021-02-09
Published Volume 10
Status Always Electronic
DOI 10.7554/eLife.61142
URL link to publisher's version