Low-trauma rib fracture in the elderly: Risk factors and mortality consequence

Mai, HT; Tran, TS; Ho-Le, TP; Pham, TT; Center, JR; Eisman, JA; Nguyen, TV

Low-trauma rib fracture in the elderly: Risk factors and mortality consequence

Mai, HT Tran, TS Ho-Le, TP Pham, TT

Center, JR Eisman, JA Nguyen, TV

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Publication Type:: Journal Article
Citation:: Bone, 2018, 116 pp. 295 - 300
Issue Date:: 2018-11-01

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Field	Value	Language
dc.contributor.author	Mai, HT	en_US
dc.contributor.author	Tran, TS	en_US
dc.contributor.author	Ho-Le, TP	en_US
dc.contributor.author	Pham, TT https://orcid.org/0000-0002-7153-0135	en_US
dc.contributor.author	Center, JR	en_US
dc.contributor.author	Eisman, JA	en_US
dc.contributor.author	Nguyen, TV https://orcid.org/0000-0002-3246-6281	en_US
dc.date.available	2018-08-23	en_US
dc.date.issued	2018-11-01	en_US
dc.identifier.citation	Bone, 2018, 116 pp. 295 - 300	en_US
dc.identifier.issn	8756-3282	en_US
dc.identifier.uri	http://hdl.handle.net/10453/127609
dc.description.abstract	© 2018 Elsevier Inc. Purpose: Low trauma rib fracture (hereinafter, rib fracture) is common in the elderly, but its risk factors and mortality consequence are rarely studied. We sought to define the epidemiology of rib fracture and the association between rib fracture and postfracture mortality. Methods: The study was part of the Dubbo Osteoporosis Epidemiology Study, which was designed as a population-based prospective study, and consisted of 2041 women and men (aged ≥ 60). The incidence of rib fracture was ascertained from X-ray reports. Bone mineral density (BMD) was measured by DXA (GE-Lunar). The time-dependent Cox model was used to access the relationship between rib fracture and mortality. Results: During the median follow-up of 13 years, 59 men and 78 women had sustained a rib fracture, making the annual incidence of 4.8/1000 person-years. Each SD (0.15 g/cm 2 ) lower in femoral neck BMD was associated with ~2-fold increase in the hazard of fracture (hazard ratio [HR] 1.9; 95% CI, 1.4 to 2.6 in men; and HR 2.1; 95% CI, 1.6 to 2.8 in women). Among those with a rib fracture, the incidence of subsequent fractures was 10.2/100 person-years. Compared with those without a fracture, the risk of mortality among those with a fracture was increased by ~7.8-fold (95% CI, 2.7 to 22.5) in men and 4.9-fold (95% CI 2.0 to 11.8) in women within the first year postfracture. Conclusions: A rib fracture signifies an increased risk of subsequent fractures and mortality. The increased risk of mortality during the first 2.5 years postfracture suggests a window of opportunity for treatment.	en_US
dc.relation.ispartof	Bone	en_US
dc.relation.isbasedon	10.1016/j.bone.2018.08.016	en_US
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject.classification	Endocrinology & Metabolism	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Rib Fractures	en_US
dc.subject.mesh	Incidence	en_US
dc.subject.mesh	Proportional Hazards Models	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Low-trauma rib fracture in the elderly: Risk factors and mortality consequence	en_US
dc.type	Journal Article
utslib.citation.volume	116	en_US
utslib.for	0903 Biomedical Engineering	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	06 Biological Sciences	en_US
utslib.for	09 Engineering	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Electrical and Data Engineering
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	closed_access	*
pubs.publication-status	Published	en_US
pubs.volume	116	en_US

Abstract:

© 2018 Elsevier Inc. Purpose: Low trauma rib fracture (hereinafter, rib fracture) is common in the elderly, but its risk factors and mortality consequence are rarely studied. We sought to define the epidemiology of rib fracture and the association between rib fracture and postfracture mortality. Methods: The study was part of the Dubbo Osteoporosis Epidemiology Study, which was designed as a population-based prospective study, and consisted of 2041 women and men (aged ≥ 60). The incidence of rib fracture was ascertained from X-ray reports. Bone mineral density (BMD) was measured by DXA (GE-Lunar). The time-dependent Cox model was used to access the relationship between rib fracture and mortality. Results: During the median follow-up of 13 years, 59 men and 78 women had sustained a rib fracture, making the annual incidence of 4.8/1000 person-years. Each SD (0.15 g/cm 2 ) lower in femoral neck BMD was associated with ~2-fold increase in the hazard of fracture (hazard ratio [HR] 1.9; 95% CI, 1.4 to 2.6 in men; and HR 2.1; 95% CI, 1.6 to 2.8 in women). Among those with a rib fracture, the incidence of subsequent fractures was 10.2/100 person-years. Compared with those without a fracture, the risk of mortality among those with a fracture was increased by ~7.8-fold (95% CI, 2.7 to 22.5) in men and 4.9-fold (95% CI 2.0 to 11.8) in women within the first year postfracture. Conclusions: A rib fracture signifies an increased risk of subsequent fractures and mortality. The increased risk of mortality during the first 2.5 years postfracture suggests a window of opportunity for treatment.

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http://hdl.handle.net/10453/127609