BMC Musculoskeletal Disorders | 2021

Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada

 
 
 
 
 
 
 
 
 
 
 

Abstract


Background The secondary fracture prevention gap in the osteoporosis field has been previously described as a ‘crisis’. Closing this gap is increasingly important in the context of accumulating evidence showing that an incident fragility fracture is associated with an increased risk of subsequent fracture within 1–2\u2009years, known as imminent fracture risk. The objective of this study was to use health services data to characterize the time between index fragility fractures occurring at different osteoporotic sites and subsequent fractures. Methods This retrospective observational study used de-identified health services data from the publicly funded healthcare system in Ontario, the largest province of Canada. Patients aged >\u200965 with an index fragility fracture occurring between 2011 and 2015 were identified from the ICES Data Repository using International Classification of Diseases (ICD)-10 codes. We examined median time to subsequent fragility fractures for osteoporotic fracture sites until the end of follow-up (2017). BMD assessment and use of osteoporosis therapies following index fracture were also characterized. Results Among 115,776 patients with an index fragility fracture, 17.8% incurred a second fragility fracture. Median time between index and second fracture occurring at any site was 555\u2009days (interquartile range: 236–955). For each index fracture site examined, median time from index to second fracture was <\u20092\u2009years. The proportion of patients with BMD assessment was 10.3% ≤1\u2009year prior\xa0to and 16.4% ≤1\u2009year post index fracture. The proportion of patients receiving osteoporosis therapy was 29.8% ≤1\u2009year prior, 34.6% ≤1\u2009year post, and 25.9% >\u20093\u2009years post index fracture. Conclusions This cohort of Canadian patients aged >\u200965\u2009years who experienced a fragility fracture at any site are at imminent risk of experiencing subsequent fracture within the next 2\u2009years and should be proactively assessed and treated.

Volume 22
Pages None
DOI 10.1186/s12891-021-04051-9
Language English
Journal BMC Musculoskeletal Disorders

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