Jonathan D Adachi1, Claudie Berger2, Rich Barron3, Derek Weycker4, Tassos P Anastassiades5, K Shawn Davison6, David A Hanley7, George Ioannidis1, Stuart A Jackson8, Robert G Josse9, Stephanie M Kaiser10, Christopher S Kovacs11, William D Leslie12, Suzanne N Morin13, Alexandra Papaioannou1, Jerilynn C Prior14, Erinda Shyta15, Amanda Silvia15, Tanveer Towheed5, David Goltzman13. 1. McMaster University, Hamilton, ON, Canada. 2. Research Institute of the McGill University Health Centre, Montreal, QC, Canada. 3. Amgen Inc., Thousand Oaks, CA, USA. 4. Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA, 02445, USA. dweycker@pai2.com. 5. Queen's University, Kingston, ON, Canada. 6. University of Victoria, Victoria, BC, Canada. 7. Cumming School of Medicine, University of Calgary, Calgary, AL, Canada. 8. University of Alberta, Edmonton, AB, Canada. 9. University of Toronto, Toronto, ON, Canada. 10. Dalhousie University, Halifax, NS, Canada. 11. Memorial University of Newfoundland, St. John's, NL, Canada. 12. University of Manitoba, Winnipeg, MB, Canada. 13. McGill University, Montreal, QC, Canada. 14. University of British Columbia, Vancouver, BC, Canada. 15. Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA, 02445, USA.
Abstract
Using data from the Canadian Multicentre Osteoporosis Study, several risk factors predictive of imminent (2-year) risk of low-trauma non-vertebral fracture among high-risk women were identified, including history of falls, history of low-trauma fracture, poorer physical function, and lower T score. Careful consideration should be given to targeting this population for therapy. PURPOSE: Fracture risk assessment has focused on a long-term horizon and populations with a broad risk range. For elderly women with osteoporosis or low bone mass, or a history of fragility fractures ("high-risk women"), risk prediction over a shorter horizon may have greater clinical relevance. METHODS: A repeated-observations design and data from the Canadian Multicentre Osteoporosis Study were employed. Study population comprised women aged ≥ 65 years with T score (total hip, femoral neck, spine) ≤ - 1.0 or prior fracture. Hazard ratios (HR) for predictors of low-trauma non-vertebral fracture during 2-year follow-up were estimated using multivariable shared frailty model. RESULTS: The study population included 3228 women who contributed 5004 observations; 4.8% experienced low-trauma non-vertebral fracture during the 2-year follow-up. In bivariate analyses, important risk factors included age, back pain, history of falls, history of low-trauma fracture, physical function, health status, and total hip T score. In multivariable analyses, only four independent predictors were identified: falls in past 12 months (≥ 2 falls: HR = 1.9; 1 fall: HR = 1.5), low-trauma fracture in past 12 months (≥ 1 fracture: HR = 1.7), SF-36 physical component summary score (≤ 42.0: HR = 1.6), and total hip T score (≤ - 3.5: HR = 3.7; > - 3.5 to ≤ - 2.5: HR = 2.5; > - 2.5 to ≤ - 1: HR = 1.3). CONCLUSIONS: Imminent risk of low-trauma non-vertebral fracture is elevated among high-risk women with a history of falls or low-trauma fracture, poorer physical function, and lower T score. Careful consideration should be given to identifying and targeting this population for therapy.
Using data from the Canadian Multicentre Osteoporosis Study, several risk factors predictive of imminent (2-year) risk of low-trauma non-vertebral fracture among high-risk women were identified, including history of falls, history of low-trauma fracture, poorer physical function, and lower T score. Careful consideration should be given to targeting this population for therapy. PURPOSE:Fracture risk assessment has focused on a long-term horizon and populations with a broad risk range. For elderly women with osteoporosis or low bone mass, or a history of fragility fractures ("high-risk women"), risk prediction over a shorter horizon may have greater clinical relevance. METHODS: A repeated-observations design and data from the Canadian Multicentre Osteoporosis Study were employed. Study population comprised women aged ≥ 65 years with T score (total hip, femoral neck, spine) ≤ - 1.0 or prior fracture. Hazard ratios (HR) for predictors of low-trauma non-vertebral fracture during 2-year follow-up were estimated using multivariable shared frailty model. RESULTS: The study population included 3228 women who contributed 5004 observations; 4.8% experienced low-trauma non-vertebral fracture during the 2-year follow-up. In bivariate analyses, important risk factors included age, back pain, history of falls, history of low-trauma fracture, physical function, health status, and total hip T score. In multivariable analyses, only four independent predictors were identified: falls in past 12 months (≥ 2 falls: HR = 1.9; 1 fall: HR = 1.5), low-trauma fracture in past 12 months (≥ 1 fracture: HR = 1.7), SF-36 physical component summary score (≤ 42.0: HR = 1.6), and total hip T score (≤ - 3.5: HR = 3.7; > - 3.5 to ≤ - 2.5: HR = 2.5; > - 2.5 to ≤ - 1: HR = 1.3). CONCLUSIONS: Imminent risk of low-trauma non-vertebral fracture is elevated among high-risk women with a history of falls or low-trauma fracture, poorer physical function, and lower T score. Careful consideration should be given to identifying and targeting this population for therapy.
Authors: Sören Möller; Michael K Skjødt; Lin Yan; Bo Abrahamsen; Lisa M Lix; Eugene V McCloskey; Helena Johansson; Nicholas C Harvey; John A Kanis; Katrine Hass Rubin; William D Leslie Journal: Osteoporos Int Date: 2021-10-01 Impact factor: 4.507
Authors: Jonathan D Adachi; Jacques P Brown; Emil Schemitsch; Jean-Eric Tarride; Vivien Brown; Alan D Bell; Maureen Reiner; Millicent Packalen; Ponda Motsepe-Ditshego; Natasha Burke; Lubomira Slatkovska Journal: BMC Musculoskelet Disord Date: 2021-02-26 Impact factor: 2.362
Authors: Emil Schemitsch; Jonathan D Adachi; Jacques P Brown; Jean-Eric Tarride; Natasha Burke; Thiago Oliveira; Lubomira Slatkovska Journal: Osteoporos Int Date: 2021-08-11 Impact factor: 4.507