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Prior fracture as a risk factor for future fracture in an Australian cohort

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Abstract

Summary

This study investigated the influence of prior fracture on the risk of subsequent fracture. There was a higher risk of subsequent fracture in both young and older adult age groups when Australian males or females had already sustained a prior fracture. Fracture prevention is important throughout life for both sexes.

Introduction

The purpose of this study was to determine the impact of prior fracture on the risk of subsequent fracture across the adult age range in Australian males and females.

Methods

All-cause fractures were grouped into age categories for males and females enrolled in the Geelong Osteoporosis Study (Australia) using retrospective self-report data and prospective radiology-confirmed data. For all age categories, the relative risk (RR and 95 % confidence interval (CI)) of subsequent fracture in a later age category was compared between those with prior fracture and those without.

Results

For both sexes, childhood fracture increased the risk of subsequent fracture in adolescence (males: RR 21.7; 95 % CI 16.0, 27.4; females: RR 8.1; 3.5, 12.8). Males with adolescent fracture had increased risk of subsequent fracture in early adulthood (RR 11.5; 5.7, 17.3) and mid-adulthood (RR 13.0; 6.3, 19.7). Additionally, males with young adulthood or mid-adulthood fracture had increased risk of subsequent fracture in the following age group (RR 11.2; 4.4, 17.9, and RR 6.2; 0.8, 11.7, respectively). Mid-adult fractures increased the risk of subsequent fracture in older adulthood (RR 6.2; 0.8, 11.7). Females with childhood or adolescent fracture had an increased risk of fracture in young adulthood (RR 4.3; 0.7, 7.9, and RR 10.5; 4.4, 16.6), and prior fracture in older adult life increased the risk of subsequent fracture in old age (RR 14.9; 6.4. 23.3).

Conclusions

Fracture prevention strategies may be more effective if attention is directed towards individuals with prior fracture at any age as they have a higher likelihood of sustaining a subsequent fracture later in life.

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Acknowledgments

The study is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia. SLB is supported by a NHMRC Early Career Fellowship, and LJW is supported by a NHMRC Career Development Fellowship.

Conflicts of interest

Kara L. Holloway, Mark A. Kotowicz, Gosia Bucki-Smith, Elizabeth N. Timney, Amelia G. Dobbins and Julie A. Pasco declare that they have no conflict of interest. Sharon L. Brennan is supported by a NHMRC Early Career Fellowship, and Lana J. Williams is supported by a NHMRC Career Development Fellowship.

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Correspondence to K. L. Holloway.

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Holloway, K.L., Brennan, S.L., Kotowicz, M.A. et al. Prior fracture as a risk factor for future fracture in an Australian cohort. Osteoporos Int 26, 629–635 (2015). https://doi.org/10.1007/s00198-014-2897-9

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  • DOI: https://doi.org/10.1007/s00198-014-2897-9

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