Per Wändell1, Xinjun Li2, Axel C Carlsson3, Jan Sundquist4, Kristina Sundquist4. 1. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. Electronic address: per.wandell@ki.se. 2. Center for Primary Health Care Research, Lund University, Malmö, Sweden. 3. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden. 4. Center for Primary Health Care Research, Lund University, Malmö, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA; Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan.
Abstract
OBJECTIVE: The aim was to analyse risk of forearm fractures in first- and second-generation immigrants to Sweden. METHODS: A nationwide study of individuals 20 years of age and older was conducted. Forearm fractures were defined as at least one registered diagnosis in the National Patient Register between January 1, 1998 and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident forearm fractures compared to Swedish-born individuals, or in second-generation immigrant groups relative to individuals with Swedish-born parents. Cox regression models were stratified by sex and adjusted for age, sociodemographic status, and co-morbidities. RESULTS: A total of 5,953,764 individuals were included in the first-generation study (2,861,256 men, and 3,092,508 women), and a forearm fracture was registered in 166,955 individuals (2.8%). The second-generation study included 4,656,023 individuals (2,368,585 men, and 2,287,438 women) with a registered forearm fracture in 111,576 individuals (2.4%). Fully adjusted HRs showed marginally lower risks when all immigrants were studied, for first-generation men 0.95 (95% CI 0.92-0.98) and women 0.95 (95% CI 95 0.92-0.97), and for second-generation men 0.93 (95% CI 0.90-0.97) and women 0.90 (95% CI 0.88-0.93). An increased risk was found among some first-generation immigrant men, especially in men from the Middle East. CONCLUSIONS: We observed a marginally lower overall risk of fractures among immigrants, but with differences among the immigrant groups.
OBJECTIVE: The aim was to analyse risk of forearm fractures in first- and second-generation immigrants to Sweden. METHODS: A nationwide study of individuals 20 years of age and older was conducted. Forearm fractures were defined as at least one registered diagnosis in the National Patient Register between January 1, 1998 and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident forearm fractures compared to Swedish-born individuals, or in second-generation immigrant groups relative to individuals with Swedish-born parents. Cox regression models were stratified by sex and adjusted for age, sociodemographic status, and co-morbidities. RESULTS: A total of 5,953,764 individuals were included in the first-generation study (2,861,256 men, and 3,092,508 women), and a forearm fracture was registered in 166,955 individuals (2.8%). The second-generation study included 4,656,023 individuals (2,368,585 men, and 2,287,438 women) with a registered forearm fracture in 111,576 individuals (2.4%). Fully adjusted HRs showed marginally lower risks when all immigrants were studied, for first-generation men 0.95 (95% CI 0.92-0.98) and women 0.95 (95% CI 95 0.92-0.97), and for second-generation men 0.93 (95% CI 0.90-0.97) and women 0.90 (95% CI 0.88-0.93). An increased risk was found among some first-generation immigrant men, especially in men from the Middle East. CONCLUSIONS: We observed a marginally lower overall risk of fractures among immigrants, but with differences among the immigrant groups.