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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/15329

Title: The role of the combination of bone and fall related risk factors on short-term subsequent fracture risk and mortality
Authors: Huntjens, Kirsten M. B.
van Geel, Tineke A. C. M.
van Helden, Svenhjalmar
Willems, Paul
Winkens, Bjorn
Brink, Peter R. G.
Issue Date: 2013
Abstract: Background: We analysed whether a combination of bone-and fall-related risk factors (RFs) in addition to a recent non-vertebral fracture (NVF) contributed to subsequent NVF risk and mortality during 2-years in patients who were offered fall and fracture prevention according to Dutch fracture-and fall-prevention guidelines. Methods: 834 consecutive patients aged >= 50 years with a recent NVF who were included. We compared subgroups of patients according to the presence of bone RFs and/or fall RFs (group 1: only bone RFs; group 2: combination of bone and fall RFs; group 3: only fall RFs; group 4: no additional RFs). Univariable and multivariable Cox regression analyses were performed adjusted for age, sex and baseline fracture location (major or minor). Results: 57 (6.8%) had a subsequent NVF and 29 (3.5%) died within 2-years. Univariable Cox regression analysis showed that patients with the combination of bone and fall RFs had a 99% higher risk in subsequent fracture risk compared to all others (Hazard Ratio (HR) 1.99; 95% Confidence Interval (CI) 1.18-3.36) Multivariable analyses this was borderline not significant (HR 1.70; 95% CI: 0.99-2.93). No significant differences in mortality were found between the groups. Conclusion: Evaluation of fall RFs contributes to identifying patients with bone RFs at highest immediate risk of subsequent NVF in spite of guideline-based treatment. It should be further studied whether earlier and immediate prevention following a NVF can decrease fracture risk in patients with a combination of bone and fall RFs.
Notes: Huntjens, KM (reprint author), Maastricht Univ Med Ctr, Sch Publ Hlth & Primary Care CAPHRI, Dept Trauma Surg, P Debyelaan 25,POB 5800, NL-6202 AZ Maastricht, Netherlands. Maastricht Univ Med Ctr, Sch Publ Hlth & Primary Care CAPHRI, Dept Trauma Surg, NL-6202 AZ Maastricht, Netherlands. Maastricht Univ Caphri, Dept Gen Practice, Maastricht, Netherlands. Isala Klin, Dept Trauma Surg, Zwolle, Netherlands. Viecuri Venlo, Dept Internal Med, Venlo, Netherlands. Maastricht Univ Med Ctr, Dept Internal Huntjens, KM (reprint author), Med, Maastricht, Netherlands. Univ Hasselt, Inst Biomed Res, Hasselt, Belgium. Maastricht Univ Med Ctr, Dept Orthopaed Surg, Maastricht, Netherlands. Maastricht Univ, Dept Methodol & Stat, Maastricht, Netherlands. k.huntjens@maastrichtuniversity.nl
URI: http://hdl.handle.net/1942/15329
DOI: 10.1186/1471-2474-14-121
ISI #: 000318625300001
ISSN: 1471-2474
Category: A1
Type: Journal Contribution
Validation: ecoom, 2014
Appears in Collections: Research publications

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