Peyman Hadji1, Bernd Schweikert2, Edda Kloppmann3, Patrick Gille4, Lars Joeres4, Emese Toth5, Luis Möckel4,6, Claus-C Glüer7,8. 1. Frankfurt Center of Bone Health, Philipps-University of Marburg, Frankfurt, Germany. 2. ICON RWESA, Munich, Germany. 3. Vilua Healthcare GmbH, Munich, Germany. 4. UCB Pharma, Monheim, Germany. 5. UCB Pharma, Brussels, Belgium. 6. HSD Hochschule Döpfer GmbH, University of Applied Sciences, Cologne, Germany. 7. Biomedical Imaging Section, Department of Radiology and Neuroradiology, Universitätskrankenhaus Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany. Glueer@rad.uni-kiel.de. 8. Department of Radiology and Neuroradiology, Molecular Imaging North Competence Center, Am Botanischen Garten 14, 24118, Kiel, Germany. Glueer@rad.uni-kiel.de.
Abstract
PURPOSE: In osteoporosis, prior fracture is a strong predictor of subsequent fracture. This study aimed to assess the imminent risk of subsequent fracture following an initial fracture in osteoporosis patients in Germany, and to identify clinical and demographic characteristics that are independently associated with subsequent fracture risk. METHODS: In this retrospective, observational cohort study using German real-world claims data, male and female patients aged ≥ 50 years with osteoporosis who experienced an initial ("index") hip/femur, vertebral, forearm/wrist/hand or shoulder/upper arm fracture between 2010 and 2014 were included. The incidence and timing of subsequent fractures during a 1-year follow-up period were analyzed. Independent risk factors for subsequent fracture were identified by multivariate regression analysis. RESULTS: A total of 18,354 patients (mean age: 77 years; standard deviation: 9.8) were included. Of these, 2918 (15.9%) suffered a subsequent fracture during the 1-year follow-up period. The incidence of subsequent fracture was higher following an index vertebral fracture (18.0%) than after an index forearm/wrist/hand fracture (14.1%) or index hip/femur fracture (12.1%). Subsequent 1-year fracture incidence was generally higher in older patients. Index fracture type, age, epilepsy/use of antiepileptics, and heart failure were all independently associated with subsequent fracture risk. CONCLUSION: Osteoporosis patients in Germany are at imminent risk of subsequent fracture during the first year following an initial fracture. They should be targeted for immediate post-fracture treatment to reduce the risk of further fractures, especially in the presence of specific risk factors such as old age or index vertebral fracture.
PURPOSE: In osteoporosis, prior fracture is a strong predictor of subsequent fracture. This study aimed to assess the imminent risk of subsequent fracture following an initial fracture in osteoporosispatients in Germany, and to identify clinical and demographic characteristics that are independently associated with subsequent fracture risk. METHODS: In this retrospective, observational cohort study using German real-world claims data, male and female patients aged ≥ 50 years with osteoporosis who experienced an initial ("index") hip/femur, vertebral, forearm/wrist/hand or shoulder/upper arm fracture between 2010 and 2014 were included. The incidence and timing of subsequent fractures during a 1-year follow-up period were analyzed. Independent risk factors for subsequent fracture were identified by multivariate regression analysis. RESULTS: A total of 18,354 patients (mean age: 77 years; standard deviation: 9.8) were included. Of these, 2918 (15.9%) suffered a subsequent fracture during the 1-year follow-up period. The incidence of subsequent fracture was higher following an index vertebral fracture (18.0%) than after an index forearm/wrist/hand fracture (14.1%) or index hip/femur fracture (12.1%). Subsequent 1-year fracture incidence was generally higher in older patients. Index fracture type, age, epilepsy/use of antiepileptics, and heart failure were all independently associated with subsequent fracture risk. CONCLUSION:Osteoporosispatients in Germany are at imminent risk of subsequent fracture during the first year following an initial fracture. They should be targeted for immediate post-fracture treatment to reduce the risk of further fractures, especially in the presence of specific risk factors such as old age or index vertebral fracture.
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