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Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study.
BMC Med. 2006 Oct 09; 4:24.BM

Abstract

BACKGROUND

Many risk factors for fractures have been documented, including low bone-mineral density (BMD) and a history of fractures. However, little is known about the short-term absolute risk (AR) of fractures and the timing of clinical fractures. Therefore, we assessed the risk and timing of incident clinical fractures, expressed as 5-year AR, in postmenopausal women.

METHODS

In total, 10 general practice centres participated in this population-based prospective study. Five years after a baseline assessment, which included clinical risk factor evaluation and BMD measurement, 759 postmenopausal women aged between 50 and 80 years, were re-examined, including undergoing an evaluation of clinical fractures after menopause. Risk factors for incident fractures at baseline that were significant in univariate analyses were included in a multivariate Cox survival regression analysis. The significant determinants were used to construct algorithms.

RESULTS

In the total group, 12.5% (95% confidence interval (CI) 10.1-14.9) of the women experienced a new clinical fracture. A previous clinical fracture after menopause and a low BMD (T-score <-1.0) were retained as significant predictors with significant interaction. Women with a recent previous fracture (during the past 5 years) had an AR of 50.1% (95% CI 42.0-58.1) versus 21.2% (95% CI 20.7-21.6) if the previous fracture had occurred earlier. In women without a fracture history, the AR was 13.8% (95% CI 10.9-16.6) if BMD was low and 7.0% (95% CI 5.5-8.5) if BMD was normal.

CONCLUSION

In postmenopausal women, clinical fractures cluster in time. One in two women with a recent clinical fracture had a new clinical fracture within 5 years, regardless of BMD. The 5-year AR for a first clinical fracture was much lower and depended on BMD.

Authors+Show Affiliations

Care and Public Health Research Institute, Department of General Practice, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. t.vangeel@hag.unimaas.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17029622

Citation

van Geel, Antonia C M., et al. "Timing and Risk Factors for Clinical Fractures Among Postmenopausal Women: a 5-year Prospective Study." BMC Medicine, vol. 4, 2006, p. 24.
van Geel AC, Geusens PP, Nagtzaam IF, et al. Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study. BMC Med. 2006;4:24.
van Geel, A. C., Geusens, P. P., Nagtzaam, I. F., Schreurs, C. M., van der Voort, D. J., Rinkens, P. E., Kester, A. D., & Dinant, G. J. (2006). Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study. BMC Medicine, 4, 24.
van Geel AC, et al. Timing and Risk Factors for Clinical Fractures Among Postmenopausal Women: a 5-year Prospective Study. BMC Med. 2006 Oct 9;4:24. PubMed PMID: 17029622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study. AU - van Geel,Antonia C M, AU - Geusens,Piet P, AU - Nagtzaam,Ivo F, AU - Schreurs,Cyril M J R, AU - van der Voort,Danny J M, AU - Rinkens,Paula E L M, AU - Kester,Arnold D M, AU - Dinant,Geert-Jan, Y1 - 2006/10/09/ PY - 2006/06/08/received PY - 2006/10/09/accepted PY - 2006/10/13/pubmed PY - 2006/11/7/medline PY - 2006/10/13/entrez SP - 24 EP - 24 JF - BMC medicine JO - BMC Med VL - 4 N2 - BACKGROUND: Many risk factors for fractures have been documented, including low bone-mineral density (BMD) and a history of fractures. However, little is known about the short-term absolute risk (AR) of fractures and the timing of clinical fractures. Therefore, we assessed the risk and timing of incident clinical fractures, expressed as 5-year AR, in postmenopausal women. METHODS: In total, 10 general practice centres participated in this population-based prospective study. Five years after a baseline assessment, which included clinical risk factor evaluation and BMD measurement, 759 postmenopausal women aged between 50 and 80 years, were re-examined, including undergoing an evaluation of clinical fractures after menopause. Risk factors for incident fractures at baseline that were significant in univariate analyses were included in a multivariate Cox survival regression analysis. The significant determinants were used to construct algorithms. RESULTS: In the total group, 12.5% (95% confidence interval (CI) 10.1-14.9) of the women experienced a new clinical fracture. A previous clinical fracture after menopause and a low BMD (T-score <-1.0) were retained as significant predictors with significant interaction. Women with a recent previous fracture (during the past 5 years) had an AR of 50.1% (95% CI 42.0-58.1) versus 21.2% (95% CI 20.7-21.6) if the previous fracture had occurred earlier. In women without a fracture history, the AR was 13.8% (95% CI 10.9-16.6) if BMD was low and 7.0% (95% CI 5.5-8.5) if BMD was normal. CONCLUSION: In postmenopausal women, clinical fractures cluster in time. One in two women with a recent clinical fracture had a new clinical fracture within 5 years, regardless of BMD. The 5-year AR for a first clinical fracture was much lower and depended on BMD. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/17029622/Timing_and_risk_factors_for_clinical_fractures_among_postmenopausal_women:_a_5_year_prospective_study_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-4-24 DB - PRIME DP - Unbound Medicine ER -