Summary

The study examined the risk factors of recurrent fragility fractures in elderly. Female and older age increased the risk of refracture. Older age at the first fracture also resulted in shorter time to the second fracture. The prevention program should be emphasized.

Purpose

The study examined the characteristics of the fragility fractures and refractures and the factors affecting the incidence and duration to the second fragility fracture.

Methods

The retrospective cohort study reviewed electronic medical records from Nan Provincial Public Health Office, Thailand. Patients aged ≥ 60 years with fragility fractures (hip, wrist, vertebra, and proximal humerus) from low-energy injuries between 1 January 2009 and 31 December 2018 were included. The characteristics of the first and second fractures and the factors that had effect on refracture incidence and duration were investigated.

Results

Among 4322 patients, 306 patients (7%) had subsequent fragility fractures. Risk factors of refracture included female (adjusted odd ratio 1.79, 95%CI 1.304–2.467) and older age at the first fracture (adjusted odd ratio 1.016, 95%CI 1.003–1.029). Factor resulted in shorter time to second fracture was older age at the first fracture (β-coefficient − 0.96, 95%CI − 1.4–(− 0.5)). Any type of the first fracture resulted in similar risk and duration to subsequent fracture. Half (48%) and two-third (65%) of the second fractures occurred within 3 and 4 years, respectively.

Conclusion

Female and older age were risk factors of subsequent fragility fracture. Older age resulted in shorter time to the second fracture. Refracture prevention program should be initiated in patients with any type of first fragility fracture and should be continued for at least 3–4 years.

中文翻译：

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老年人脆性骨折后再骨折的危险因素

概括

该研究调查了老年人复发性脆性骨折的危险因素。女性和年龄较大会增加再骨折的风险。第一次骨折时年龄较大也导致第二次骨折的时间较短。应强调预防方案。

目的

该研究检查了脆性骨折和再骨折的特征以及影响二次脆性骨折发生率和持续时间的因素。

方法

回顾性队列研究审查了泰国难府公共卫生办公室的电子病历。纳入了 2009 年 1 月 1 日至 2018 年 12 月 31 日期间因低能量损伤导致的年龄≥60 岁的脆性骨折（髋部、腕部、椎骨和肱骨近端）患者。探讨第一次、第二次骨折的特点及影响再骨折发生率和持续时间的因素。

结果

在 4322 名患者中，306 名患者 (7%) 随后发生了脆性骨折。再骨折的危险因素包括女性（调整后的比值比 1.79，95%CI 1.304-2.467）和首次骨折时年龄较大（调整后的比值比 1.016，95%CI 1.003-1.029）。导致第二次骨折时间较短的因素是第一次骨折时年龄较大（β 系数 − 0.96，95% CI − 1.4–（− 0.5））。任何类型的第一次骨折都会导致与后续骨折相似的风险和持续时间。一半 (48%) 和三分之二 (65%) 的二次骨折分别发生在 3 年和 4 年内。

结论

女性和年龄较大是后续脆性骨折的危险因素。年龄越大，第二次骨折的时间越短。任何类型的首次脆性骨折患者都应启动再骨折预防计划，并应持续至少 3-4 年。