Recent vertebral fractures predict future fractures
MedWire News: Prevalent and recent vertebral fractures are strongly predictive of subsequent new and severe vertebral fractures and identify women who should be given priority bone healthcare, study findings suggest.
It is well established that prior vertebral fracture predicts future vertebral fracture as well as non-vertebral and hip fractures, explain Dennis Black (University of California, San Francisco, USA) and colleagues.
"While the severity of a prevalent vertebral fracture has been shown to predict future fractures," the researchers add, "little has been done to determine predictors of severe incident vertebral fractures, which is relevant because the severity of a vertebral fracture not only predicts future fractures but can also cause a greater reduction in quality of life and health."
To identify predictors of new and severe vertebral fractures, and establish how these predict future fracture risk, Black and team analyzed data from the placebo arm of an international trial of post-menopausal women with osteoporosis aged 65-85 years. The current study included data from 2677 participants who had had annual spinal radiographs taken.
As reported in the journal Osteoporosis International, the risk of a new vertebral fracture during year 2-3 of the trials was 3.9% in those who had not suffered a vertebral fracture before entering the trial or during the first year of the trial, and 29.8% in women who had either experienced a fracture at some point before being recruited in the trial or during the first year of the trial.
After adjustment for potentially confounding factors, a history of fracture before or during the first year of the trial was shown to be associated with a more than three-fold increased risk for new vertebral fracture. Of the two risk factors, fracture during the first year of the study was found to be more predictive of subsequent fracture than fractures that occurred at any point before the study started.
"Our study allows clinicians to identify a group of particularly high-risk women for whom treatment is particularly urgent," conclude the investigators.
"We hope that clinicians will recognize the extremely high risk for these patients," the authors add, "and ensure that they are properly treated before they sustain multiple and more severe vertebral compression fractures."
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By Philip Ford