Fracture risk following high-trauma versus low-trauma fracture: a registry-based cohort study

Summary Prior high-trauma fractures identified through health services data are associated with low bone mineral density (BMD) and future fracture risk to the same extent as fractures without high-trauma. Introduction Some have questioned the usefulness of distinguishing high-trauma fractures from l...

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Bibliographic Details
Published in:Osteoporosis international 2020-06, Vol.31 (6), p.1059-1067
Main Authors: Leslie, W. D., Schousboe, J. T., Morin, S. N., Martineau, P., Lix, L. M., Johansson, H., McCloskey, E. V., Harvey, N. C., Kanis, J. A.
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Adult
Age
Aged
Bone Density
Bone mineral density
Cohort analysis
Cohort Studies
Endocrinology
Female
Fractures
Fractures, Bone - classification
Health risk assessment
Hip
Humans
Male
Manitoba - epidemiology
Medicine
Medicine & Public Health
Middle Aged
Original Article
Orthopedics
Osteoporosis
Osteoporotic Fractures - complications
Osteoporotic Fractures - epidemiology
Population studies
Registries
Rheumatology
Risk Assessment
Risk Factors
Trauma
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Summary:Summary Prior high-trauma fractures identified through health services data are associated with low bone mineral density (BMD) and future fracture risk to the same extent as fractures without high-trauma. Introduction Some have questioned the usefulness of distinguishing high-trauma fractures from low-trauma fractures. The aim of this study is to compare BMD measurements and risk of subsequent low-trauma fracture in patients with prior high- or low-trauma fractures. Methods Using a clinical BMD registry for the province of Manitoba, Canada, we identified women and men age 40 years or older with fracture records from linked population-based healthcare data. Age- and sex-adjusted BMD Z-scores and covariate-adjusted hazard ratios (HR) with 95% confidence intervals (CI) for incident fracture were studied in relation to prior fracture status, categorized as high-trauma if associated with external injury codes and low-trauma otherwise. Results The study population consisted of 64,428 women and men with no prior fracture (mean age 63.7 years), 858 with prior high-trauma fractures (mean age 65.1 years), and 14,758 with prior low-trauma fractures (mean age 67.2 years). Mean Z-scores for those with any prior high-trauma fracture were significantly lower than in those without prior fracture ( P  
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-019-05274-2