Ronald Man Yeung Wong1, Wing Tung Ho1, Law Sheung Wai1, Wilson Li2, Wai Wang Chau1, Kwoon-Ho Simon Chow1, Wing-Hoi Cheung3. 1. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, 5/F, Lui Che Woo Clinical Sciences Building, Shatin, New Territories, Hong Kong SAR, China. 2. Department of Orthopaedics & Traumatology, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR, China. 3. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, 5/F, Lui Che Woo Clinical Sciences Building, Shatin, New Territories, Hong Kong SAR, China. louis@ort.cuhk.edu.hk.
Abstract
INTRODUCTION: Imminent fracture risk, or fractures within 2 years of an initial fracture, is a pressing issue worldwide. Hong Kong is a city with one of the longest life expectancies. The concern of fragility fractures and the imminent risk of a subsequent fracture is becoming a top priority. The objective of this study was to present the epidemiology of incident fragility fractures of all public acute hospitals and the imminent risk of a subsequent fracture in Hong Kong. METHODOLOGY: This was a retrospective population-based analysis. Patient records from all acute hospitals in Hong Kong from 1 January 2004 to 31 December 2018 were retrieved for patients ≥ 50 years of age with hip, distal radius, or proximal humerus fractures. Secondary fractures and falls were identified in the subsequent 5 years. Post hoc analysis in recent 2013-2018 period was performed. Overall survival (re-fracture incidence) on age subgroups using Kaplan survival analysis and variables was compared using the log-rank test. Cox proportional hazard regressions, obtaining the hazard ratios (HR) and their respective 95% confidence intervals (CI), were used. RESULTS: There is an overall increasing trend of fragility fractures (hip, distal radius, proximal humerus) from 5596 in 2004 to 8465 in 2018. The average cumulative imminent risk of fractures from recent 5 years is 3.87% at 1 year and 6.50% at 2 years. 49.5% of the patients with a secondary fracture occurred within 2 years since the initial major fragility fracture. Post hoc analysis in recent 2013-2018 period (N = 7039) showed male patients were 1.21 times more likely to have further fractures with time (HR = 1.21 (1.02, 1.45), p = 0.03) compared with female patients. Patients over age 95 were 2.01 times higher than patients of age under 75 to have further fracture over time. CONCLUSIONS: Following an initial fracture, prompt treatment strategies should be adopted to avoid imminent risk of fractures. This window of opportunity in the first 2 years is a golden period to treat osteoporosis and prevent falls. Our post hoc analysis has shown that male patients and patients older than 95 are at even higher risk. Clinicians and allied healthcare professionals should be alert on these patients.
INTRODUCTION: Imminent fracture risk, or fractures within 2 years of an initial fracture, is a pressing issue worldwide. Hong Kong is a city with one of the longest life expectancies. The concern of fragility fractures and the imminent risk of a subsequent fracture is becoming a top priority. The objective of this study was to present the epidemiology of incident fragility fractures of all public acute hospitals and the imminent risk of a subsequent fracture in Hong Kong. METHODOLOGY: This was a retrospective population-based analysis. Patient records from all acute hospitals in Hong Kong from 1 January 2004 to 31 December 2018 were retrieved for patients ≥ 50 years of age with hip, distal radius, or proximal humerus fractures. Secondary fractures and falls were identified in the subsequent 5 years. Post hoc analysis in recent 2013-2018 period was performed. Overall survival (re-fracture incidence) on age subgroups using Kaplan survival analysis and variables was compared using the log-rank test. Cox proportional hazard regressions, obtaining the hazard ratios (HR) and their respective 95% confidence intervals (CI), were used. RESULTS: There is an overall increasing trend of fragility fractures (hip, distal radius, proximal humerus) from 5596 in 2004 to 8465 in 2018. The average cumulative imminent risk of fractures from recent 5 years is 3.87% at 1 year and 6.50% at 2 years. 49.5% of the patients with a secondary fracture occurred within 2 years since the initial major fragility fracture. Post hoc analysis in recent 2013-2018 period (N = 7039) showed male patients were 1.21 times more likely to have further fractures with time (HR = 1.21 (1.02, 1.45), p = 0.03) compared with female patients. Patients over age 95 were 2.01 times higher than patients of age under 75 to have further fracture over time. CONCLUSIONS: Following an initial fracture, prompt treatment strategies should be adopted to avoid imminent risk of fractures. This window of opportunity in the first 2 years is a golden period to treat osteoporosis and prevent falls. Our post hoc analysis has shown that male patients and patients older than 95 are at even higher risk. Clinicians and allied healthcare professionals should be alert on these patients.
Authors: R M Y Wong; R W K Ng; W W Chau; W H Liu; S K H Chow; C Y Tso; N Tang; W-H Cheung Journal: Osteoporos Int Date: 2022-06-28 Impact factor: 5.071
Authors: Ronald Man Yeung Wong; Wing-Hoi Cheung; Simon Kwoon Ho Chow; Raymond Wai Kit Ng; Wilson Li; Albert Yung-Chak Hsu; Kam Kwong Wong; Angela Wing-Hang Ho; Shing-Hing Choi; Christian Xinshuo Fang; Chun Fung Chan; Ka-Hei Leung; Kwok-Keung Chu; Timothy Chi Yui Kwok; Ming Hui Yang; Maoyi Tian; Sheung Wai Law Journal: J Orthop Translat Date: 2022-10-10 Impact factor: 4.889
Authors: R M Y Wong; K C Chong; S W Law; W T Ho; J Li; C S Chui; S K H Chow; W H Cheung Journal: J Orthop Translat Date: 2020-06-01 Impact factor: 5.191
Authors: E V McCloskey; F Borgstrom; C Cooper; N C Harvey; M K Javaid; M Lorentzon; J A Kanis Journal: Osteoporos Int Date: 2021-04-29 Impact factor: 4.507
Authors: Ronald Man Yeung Wong; Pui Yan Wong; Chaoran Liu; Yik Lok Chung; Kwok Chuen Wong; Chi Yin Tso; Simon Kwoon-Ho Chow; Wing-Hoi Cheung; Patrick Shu-Hang Yung; Chun Sing Chui; Sheung Wai Law Journal: Bone Joint Res Date: 2021-12 Impact factor: 5.853
Authors: Ronald Man Yeung Wong; Yao Zu; Wai Wang Chau; Chi Yin Tso; Wing Hong Liu; Raymond Wai Kit Ng; Simon Kwoon Ho Chow; Wing Hoi Cheung; Ning Tang; Kevin Ki Wai Ho Journal: Sci Rep Date: 2022-03-19 Impact factor: 4.379
Authors: Jie Li; Ronald Man Yeung Wong; Yik Lok Chung; Sharon Shui Yee Leung; Simon Kwoon-Ho Chow; Margaret Ip; Wing-Hoi Cheung Journal: Bone Joint Res Date: 2022-02 Impact factor: 5.853