アブストラクト | RATIONALE: Adults with a recent fracture have a high imminent risk of a subsequent fracture. We hypothesise that, like subsequent fracture risk, fall risk is also highest immediately after a fracture. This study aims to assess if fall risk is time-dependent in subjects with a recent fracture compared to subjects without a fracture. METHODS: This retrospective matched cohort study used data from the UK Clinical Practice Research Datalink GOLD. All subjects >/=50 years with a fracture between 1993 and 2015 were identified and matched one-to-one to fracture-free controls based on year of birth, sex and practice. The cumulative incidence and relative risk (RR) of a first fall was calculated at various time intervals, with mortality as competing risk. Subsequently, analyses were stratified according to age, sex and type of index fracture. RESULTS: A total of 624,460 subjects were included; 312,230 subjects with an index fracture, matched to 312,230 fracture-free controls (71% females, mean age 70 +/- 12, mean follow-up 6.5 +/- 5 years). The RR of falls was highest in the first year after fracture compared to fracture-free controls; males had a 3-fold and females a 2-fold higher risk. This imminent fall risk was present in all age and fracture types and declined over time. A concurrent imminent fracture and mortality risk were confirmed. CONCLUSION/DISCUSSION: This study demonstrates an imminent fall risk in the first years after a fracture in all age and fracture types. This underlines the need for early fall risk assessment and prevention strategies in 50+ adults with a recent fracture. |
投稿者 | Schene, Merle R; Wyers, Caroline E; Driessen, Annemariek M H; Souverein, Patrick C; Gemmeke, Marle; van den Bergh, Joop P; Willems, Hanna C |
組織名 | Department of Internal Medicine, VieCuri Medical Center, P.O. Box 1926, 5900 BX;Venlo, The Netherlands.;NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht;University, Maastricht, The Netherlands.;Internal Medicine and Geriatrics, Amsterdam UMC Location University of Amsterdam,;Amsterdam, The Netherlands.;Department of Internal Medicine, Maastricht University Medical Center +, P.O. Box;616, 6200 MD Maastricht, The Netherlands.;Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands.;Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht,;The Netherlands.;CARIM School of Cardiovascular Disease, Maastricht University Medical Centre+,;Maastricht, The Netherlands.;Amsterdam Bone Center, Movement Sciences Amsterdam, Amsterdam, The Netherlands. |