RESEARCH - Clinical subsequent fractures cluster in time after first fractures

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Ann Rheum Dis. Published Online First: 3 August 2008.

doi:10.1136/ard.2008.092775

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Concise Report

Clinical subsequent fractures cluster in time after first fractures

Tineke ACM van Geel 1*, Svenhjalmar van Helden 2, Piet P Geusens 2,

Bjorn Winkens 1 and Geert-Jan Dinant 1

1 Maastricht University, Netherlands

2 Maastricht University Medical Centre, Netherlands

Abstract

Objectives: The risk of subsequent fractures is double the risk of

having a first fracture. We analysed whether this risk is constant or

not over time.

Methods: A population-based study in 4140 postmenopausal women, aged

between 50 and 90 years, on radiographic confirmed clinical fractures

from menopause onwards analysed by regression.

Results: 924 (22%) women had a first fracture and 234 (26% of 924) a

subsequent fracture. Four percent of all first fractures occurred in

each year from menopause onwards, while after a first fracture, 23% of

all subsequent fractures occurred within one year and 54% within five

years. When calculated from time of a first fracture, the relative

risk (RR) of subsequent fracture was 2.1 (95% confidence interval

(CI): 1.7-2.6) and remained increased during 15 years. When calculated

for specific time intervals after a first fracture, the RR was 5.3

(CI: 4.0-6.6) within one year, 2.8 (CI: 2.0-3.6) within 2-5 years, 1.4

(1.0-1.8) within 6-10 years and 0.41 (CI: 0.29 -0.53) after >10 years.

Conclusions: From menopause onwards, clinical fractures cluster in

time indicating the need for early action to prevent subsequent

fractures.

http://ard.bmj.com/cgi/content/abstract/ard.2008.092775v1?papetoc

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