Association between incident falls and subsequent fractures in patients attending the fracture liaison service after an index fracture: a 3-year prospective observational cohort study.

Vranken, L; Wyers, CE; Van der Velde, RY; Janzing, HMJ; Kaarsemakers, S; Driessen, J; Eisman, J; Center, JR; Nguyen, TV; Tran, T; Bliuc, D; Geusens, P; van den Bergh, JP

Association between incident falls and subsequent fractures in patients attending the fracture liaison service after an index fracture: a 3-year prospective observational cohort study.

Vranken, L Wyers, CE Van der Velde, RY Janzing, HMJ Kaarsemakers, S Driessen, J Eisman, J Center, JR Nguyen, TV Tran, T Bliuc, D Geusens, P van den Bergh, JP

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Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: BMJ Open, 2022, 12, (7), pp. e058983
Issue Date:: 2022-07-27

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Field	Value	Language
dc.contributor.author	Vranken, L
dc.contributor.author	Wyers, CE
dc.contributor.author	Van der Velde, RY
dc.contributor.author	Janzing, HMJ
dc.contributor.author	Kaarsemakers, S
dc.contributor.author	Driessen, J
dc.contributor.author	Eisman, J
dc.contributor.author	Center, JR
dc.contributor.author	Nguyen, TV
dc.contributor.author	Tran, T
dc.contributor.author	Bliuc, D
dc.contributor.author	Geusens, P
dc.contributor.author	van den Bergh, JP
dc.date.accessioned	2022-09-22T11:43:17Z
dc.date.available	2022-09-22T11:43:17Z
dc.date.issued	2022-07-27
dc.identifier.citation	BMJ Open, 2022, 12, (7), pp. e058983
dc.identifier.issn	2044-6055
dc.identifier.issn	2044-6055
dc.identifier.uri	http://hdl.handle.net/10453/161994
dc.description.abstract	OBJECTIVES: To evaluate the risk of subsequent fractures in patients who attended the Fracture Liaison Service (FLS), with and without incident falls after the index fracture. DESIGN: A 3-year prospective observational cohort study. SETTING: An outpatient FLS in the Netherlands. PARTICIPANTS: Patients aged 50+ years with a recent clinical fracture. OUTCOME MEASURES: Incident falls and subsequent fractures. RESULTS: The study included 488 patients (71.9% women, mean age: 64.6±8.6 years). During the 3-year follow-up, 959 falls had been ascertained in 296 patients (60.7%) (ie, fallers), and 60 subsequent fractures were ascertained in 53 patients (10.9%). Of the fractures, 47 (78.3%) were fall related, of which 25 (53.2%) were sustained at the first fall incident at a median of 34 weeks. An incident fall was associated with an approximately 9-fold (HR: 8.6, 95% CI 3.1 to 23.8) increase in the risk of subsequent fractures. CONCLUSION: These data suggest that subsequent fractures among patients on treatment prescribed in an FLS setting are common, and that an incident fall is a strong predictor of subsequent fracture risk. Immediate attention for fall risk could be beneficial in an FLS model of care. TRIAL REGISTRATION NUMBER: NL45707.072.13.
dc.format	Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation.ispartof	BMJ Open
dc.relation.isbasedon	10.1136/bmjopen-2021-058983
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.mesh	Accidental Falls
dc.subject.mesh	Aged
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Incidence
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Netherlands
dc.subject.mesh	Osteoporosis
dc.subject.mesh	Osteoporotic Fractures
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	Osteoporosis
dc.subject.mesh	Incidence
dc.subject.mesh	Risk Factors
dc.subject.mesh	Cohort Studies
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Accidental Falls
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Netherlands
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Osteoporotic Fractures
dc.title	Association between incident falls and subsequent fractures in patients attending the fracture liaison service after an index fracture: a 3-year prospective observational cohort study.
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
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
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-22T11:43:14Z
pubs.issue	7
pubs.publication-status	Published online
pubs.volume	12
utslib.citation.issue	7

Abstract:

OBJECTIVES: To evaluate the risk of subsequent fractures in patients who attended the Fracture Liaison Service (FLS), with and without incident falls after the index fracture. DESIGN: A 3-year prospective observational cohort study. SETTING: An outpatient FLS in the Netherlands. PARTICIPANTS: Patients aged 50+ years with a recent clinical fracture. OUTCOME MEASURES: Incident falls and subsequent fractures. RESULTS: The study included 488 patients (71.9% women, mean age: 64.6±8.6 years). During the 3-year follow-up, 959 falls had been ascertained in 296 patients (60.7%) (ie, fallers), and 60 subsequent fractures were ascertained in 53 patients (10.9%). Of the fractures, 47 (78.3%) were fall related, of which 25 (53.2%) were sustained at the first fall incident at a median of 34 weeks. An incident fall was associated with an approximately 9-fold (HR: 8.6, 95% CI 3.1 to 23.8) increase in the risk of subsequent fractures. CONCLUSION: These data suggest that subsequent fractures among patients on treatment prescribed in an FLS setting are common, and that an incident fall is a strong predictor of subsequent fracture risk. Immediate attention for fall risk could be beneficial in an FLS model of care. TRIAL REGISTRATION NUMBER: NL45707.072.13.

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http://hdl.handle.net/10453/161994