Study: Non-hip, non-vertebral fractures increase risk of subsequent fracture, mortality

Non-hip, non-vertebral fractures increase the risk of mortality, and the risk is higher in men than women, according to a recent study from researchers in Australia.

The researchers used a competing risk model to examine risk of subsequent fracture and mortality in patients enrolled in the Dubbo Osteoporosis Epidemiology Study. Of these patients, they identified 952 fractures in women and 342 fractures in men who were aged 60 years or older.

“The competing risk model can have three outcomes – mortality following the initial fracture, risk of refracture and risk of mortality following refracture,” Dana Bliuc, MMed, MD, from the Garvan Institute of Medical Research in Sydney, Australia, stated in a press release. “When we looked at mortality following the initial fracture, we observed that it is very high for all fracture types for the first 5 years following fracture. It then declines towards the general population mortality risk.”

Non-hip fractures carried a 20% additional risk for mortality the first 5 years after the injury, and consisted of initial fractures in 50% of cases and subsequent fractures in the remaining cases, according to the abstract.

“The same competing risk model showed a compounded risk of mortality following re-fracture. In the 5 years after initial fracture, about another third of people experience a re-fracture. These people again experience excess mortality – and men fare a lot worse than women. For example, if a man has another fracture after an initial hip fracture we observed an 80% to 90% mortality risk.”

Bliuc and colleagues recommended early intervention for any patients who sustain a non-hip, non-vertebral fracture to reduce the risk of re-fracture and mortality.

Reference:

Bliuc D. J Clin Endocrinol Metab. 2013;doi:10.1210/jc.2013-3461.

Disclosure: One of the authors (Center) received research support from Amgen, Merck Sharp and Dohme, Novartis and Sanofi-Aventis.