Thach Tran1, Dana Bliuc1, Louise Hansen2, Bo Abrahamsen3,4, Joop van den Bergh5,6, John A Eisman1,7,8,9,10, Tineke van Geel11, Piet Geusens12,13, Peter Vestergaard14,15, Tuan V Nguyen1,8, Jacqueline R Center1,7,8. 1. Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia. 2. Danish Center for Healthcare Improvements, Department of Business and Management, Aalborg University, Aalborg East, Denmark. 3. Department of Medicine, Holbæk Hospital, Holbæk, Denmark. 4. Department of Clinical Research, Odense Patient Data Explorative Network, University of Southern Denmark, Odense, Denmark. 5. Maastricht University Medical Center, Research School Nutrim, Department of Internal Medicine, Subdivision of Rheumatology, Maastricht, Netherlands. 6. VieCuri Medical Centre of Noord-Limburg, Department of Internal Medicine, BX Venlo, Netherlands. 7. Clinical School, St Vincent's Hospital, Sydney, New South Wales, Australia. 8. Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. 9. Clinical Translation and Advanced Education, Garvan Institute of Medical Research, Sydney, New South Wales, Australia. 10. School of Medicine Sydney, University of Notre Dame Australia, Sydney, New South Wales, Australia. 11. Maastricht University, Research School CAPHRI, Department of Family Medicine, Maastricht, Netherlands. 12. Maastricht University Medical Center, Research School CAPHRI, Department of Internal Medicine, Subdivision of Rheumatology, Maastricht, Netherlands. 13. University Hasselt, Biomedical Research Institute, Hasselt, Belgium. 14. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 15. Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
Abstract
Context: Little is known about long-term excess mortality following fragility nonhip fractures. Objective: The study aimed to determine which fracture was associated with excess mortality and for how long the postfracture excess mortality persisted. Design, Setting, and Patients: This nationwide registry-based follow-up study included all individuals in Denmark aged 50+ years who first experienced fragility fractures in 2001 and were followed up for up to 10 years for their mortality risk. Main Outcome Measure: The contribution of fracture to mortality at precise postfracture time intervals was examined using relative survival analysis, accounting for time-related mortality changes in the background population. Results: There were 21,123 women (aged 72 ± 13 years) and 9481 men (aged 67 ± 12 years) with an incident fragility fracture in 2001, followed by 10,668 and 4745 deaths, respectively. Excess mortality was observed following all proximal and lower leg fractures. The majority of deaths occurred within the first year after fracture, and thereafter excess mortality gradually declined. Hip fractures were associated with the highest excess mortality (33% and 20% at 1 year after fracture in men and women, respectively). One-year excess mortality after fracture of a femur or pelvis was 20% to 25%; vertebrae, 10%; humerus, rib, or clavicle, 5% to 10%; and lower leg, 3%. A significant although smaller excess mortality was still observed until 10 years for hip fractures and ~5 years after femur, other proximal, and lower leg fractures. Conclusion: This study highlights the important contribution of a wide variety of fragility fractures to long-term excess mortality and thus the potential for benefit from early intervention.
Context: Little is known about long-term excess mortality following fragility nonhip fractures. Objective: The study aimed to determine which fracture was associated with excess mortality and for how long the postfracture excess mortality persisted. Design, Setting, and Patients: This nationwide registry-based follow-up study included all individuals in Denmark aged 50+ years who first experienced fragility fractures in 2001 and were followed up for up to 10 years for their mortality risk. Main Outcome Measure: The contribution of fracture to mortality at precise postfracture time intervals was examined using relative survival analysis, accounting for time-related mortality changes in the background population. Results: There were 21,123 women (aged 72 ± 13 years) and 9481 men (aged 67 ± 12 years) with an incident fragility fracture in 2001, followed by 10,668 and 4745 deaths, respectively. Excess mortality was observed following all proximal and lower leg fractures. The majority of deaths occurred within the first year after fracture, and thereafter excess mortality gradually declined. Hip fractures were associated with the highest excess mortality (33% and 20% at 1 year after fracture in men and women, respectively). One-year excess mortality after fracture of a femur or pelvis was 20% to 25%; vertebrae, 10%; humerus, rib, or clavicle, 5% to 10%; and lower leg, 3%. A significant although smaller excess mortality was still observed until 10 years for hip fractures and ~5 years after femur, other proximal, and lower leg fractures. Conclusion: This study highlights the important contribution of a wide variety of fragility fractures to long-term excess mortality and thus the potential for benefit from early intervention.
Authors: D Alarkawi; D Bliuc; T Tran; L A Ahmed; N Emaus; A Bjørnerem; L Jørgensen; T Christoffersen; J A Eisman; J R Center Journal: Osteoporos Int Date: 2019-10-26 Impact factor: 4.507
Authors: Jason Talevski; Kerrie M Sanders; Sara Vogrin; Gustavo Duque; Alison Beauchamp; Ego Seeman; Sandra Iuliano; Axel Svedbom; Fredrik Borgström; John A Kanis; Amanda L Stuart; Sharon L Brennan-Olsen Journal: Arch Osteoporos Date: 2021-07-15 Impact factor: 2.617
Authors: Chae Won Chung; Hoon Sung Choi; Sung Hye Kong; Young Joo Park; Do Joon Park; Hwa Young Ahn; Sun Wook Cho Journal: J Clin Med Date: 2021-05-03 Impact factor: 4.241
Authors: N Li; M Hiligsmann; A Boonen; M M van Oostwaard; R T A L de Bot; C E Wyers; S P G Bours; J P van den Bergh Journal: Osteoporos Int Date: 2021-04-07 Impact factor: 4.507