Department of Internal Medicine, VieCuri Medical Centre, PO Box 1926, 5900 BX, Venlo, The Netherlands.
Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD, Maastricht, The Netherlands.
Osteoporos Int. 2018 Nov;29(11):2469-2475. doi: 10.1007/s00198-018-4636-0. Epub 2018 Jul 20.
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.
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.
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.
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.
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.
研究 1990 年至 2012 年间 50 岁以上人群中随后发生骨折的发生率，以及股骨/髋部骨折后发生随后骨折的相对风险（RR），并按每 5 岁年龄组分层。患有骨折的患者随后发生骨折的发生率很高；股骨/髋部骨折后发生随后骨折的 RR 范围为 2 至 7。
我们使用英国临床实践研究数据链接（CPRD）进行了一项回顾性观察性研究。通过将观察到的骨折数除以风险人数年（py）来计算特定部位随后骨折的发生率。通过将特定后续骨折类型的发生率除以同一年龄组同一部位的首次骨折发生率来计算股骨/髋部骨折后发生后续骨折的 RR（按 5 岁年龄组划分）。
股骨/髋部骨折后发生的最高后续骨折发生率是男性的肱骨骨折（59.5/10.000 py）和女性的桡骨/尺骨骨折（117.2/10.000 py）。在桡骨/尺骨骨折的指数骨折后，男性的肱骨骨折（59.3/10.000 py）和女性的股骨/髋部骨折（82.4/10.000 py）最为常见。股骨/髋部骨折后的 RR 范围为 2 至 7，在男性和年轻年龄组中最高。
患有骨折的患者发生随后骨折的发生率很高。我们的研究结果表明，通过充分的医疗诊断和治疗，对有骨折病史的患者进行骨折预防非常重要。
