Low-trauma fracture should alert clinicians to future hip fracture risk
MedWire News: One in five elderly nursing home residents with a low-trauma non-hip fracture will ultimately fracture their hip in the following 2.5 years, Australian study data show.
"Accordingly, despite their advanced age, [these people] are a high-priority target group to investigate interventions that might reduce the risk of hip fracture," say Jian Sheng Chen (University of Sydney) and colleagues.
"It has been well documented that a fragility fracture increases the risk of future fracture in community-dwellers," say the researchers. "This increase appears to be greater in the younger age group and in the first few years following a fracture but can last up to 10 years," they add.
To investigate whether the increased risk for subsequent fracture also occurs among elderly people - who often already have a history of fracture - Chen and team carried out a prospective study of 1412 elderly residents (mean age 86.2 years, 77% women) living in nursing homes and intermediate-care nursing care facilities in Australia.
The team recorded the number of fractures that occurred over a 2-year period then divided the participants into those without fractures, those with a non-hip fracture, and those with a hip fracture. The risk for subsequent hip fracture was compared among the groups.
In comparison with residents without a fracture, those with a non-hip fracture in the first 2 years (n=194) had a significantly increased risk for subsequent hip fracture for the next 2.5 years, whereas those with a hip fracture (n=101) had no subsequent increase in risk for hip fracture.
During the 2.5 years, the probability of subsequent hip fracture was 19.9%, 10.4%, and 8.0% for the non-hip fracture group, the hip fracture group, and the nonfracture group, respectively.
Multivariate analysis indicated that people in the non-hip fracture group had a significant 2.8-fold increased risk for future hip fracture, compared with the nonfracture group, even after adjustment for previous fracture history and other potentially confounding factors.
Writing in the Journal Bone and Mineral Research, Chen and co-authors conclude that their findings "provide a rationale for health care providers to encourage physicians treating frail older people with a newly acquired fracture to take measures to prevent subsequent fractures."
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By Laura Dean