Osteoporosis & bone health

Are there specific clinical risk factors for the occurrence of multiple fractures? The FRISBEE study

Osteoporos IntPublished Prospective cohort study

Authors' conclusion

We found in a prospective cohort study that there were more CRFs and higher hazard ratios for the occurrence of multiple fractures than for a single fracture.

Study context

Population
Postmenopausal women of the FRISBEE studyfollowed 9.1 (7.2–10.6) years
Participants
3,560 women
Exposure
Multiple incident fractures vs single incident fracture vs no incident fracture
  • Multiple fracturesn = 261
  • Single fracturen = 628
  • No fracturen = 2,671reference
Outcome
Clinical risk factors specifically increasing the risk of multiple fractures
Methodological detailsCox proportional hazards models, annual collection of clinical risk factors (CRFs) and fractures
  • Cox proportional hazards models
  • Annual collection of CRFs and fractures

Main finding

As reported in the abstract

Risk factors for multiple fractures
  • Risk factors for multiple fractures at any site: age, history of fracture, history of fall, total hip bone mineral density (BMD), spine BMD and RA
  • Significant CRFs for multiple major osteoporotic fractures (MOFs): age, history of fracture, parental hip fracture, total hip BMD and RA
  • More CRFs and higher HRs for multiple fractures than for a single fracture

Observational data: associations, not effects.

Further findings

Events

OutcomeMultiple fracturesSingle fracture
Major osteoporotic fractures (MOFs)146435
Major osteoporotic fractures (MOFs) — No MOF
2979

Central fractures

Two or more central fractures
157
Only one central fracture
389
No central fracture
3014

Original publication

Are there specific clinical risk factors for the occurrence of multiple fractures? The FRISBEE study. Osteoporos Int. Published 4 January 2023. doi:10.1007/s00198-022-06663-w

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