Fracture liaison service (FLS) is associated with lower subsequent fragility fracture risk and mortality: NoFRACT (the Norwegian capture the fracture initiative)
Authors' conclusion
A standardized FLS intervention was associated with a lower risk of subsequent fragility fractures and mortality and may contribute to reduce the global fracture burden.
Study context
- Population
- Patients over 50 years with a low-energy fracture, Norwegian Patient Registrymean age 69.6 years
- Participants
- 100,198 participants
- Comparison
- FLS intervention period vs control period
- Primary endpoint
- Subsequent fragility fractures (distal forearm, proximal humerus, or hip) and all-cause mortality
Methodological detailsmulticenter, pragmatic, register-supported, cluster-randomized, FLS introduced in three clusters with 4-month intervals, May 2015 through December 2018
- Multicenter
- Pragmatic
- Register-supported
- Cluster-randomized
- FLS introduced in three clusters with 4-month intervals, May 2015 through December 2018
Primary result
As reported in the abstract
Subsequent fragility fracture · maximum follow-up of 4.7 years
FLS vs ControlEstimate (95% CI)
13% lower risk in women
HR (women) 0.87(0.83–0.92)
10% lower risk in men
HR (men) 0.90(0.81–0.99)
- Women with a subsequent fragility fracture (overall)
- 11% (6948)
- Men with a subsequent fragility fracture (overall)
- 6% (2014)
Further findings
| Outcome | Estimate | |
|---|---|---|
| All-cause mortality · maximum follow-up of 4.7 yearsFLSvs Control18% lower mortality in women | HR (women) 0.82 (95% CI 0.79–0.86) | |
| All-cause mortality · maximum follow-up of 4.7 yearsFLSvs Control15% lower mortality in men | HR (men) 0.85 (95% CI 0.81–0.89) | |
| 0.512Ratio (log scale) |
- All-cause mortality — Women who died (overall)
- 20% (14,324)
- All-cause mortality — Men who died (overall)
- 22% (8,326)
Original publication
Fracture liaison service (FLS) is associated with lower subsequent fragility fracture risk and mortality: NoFRACT (the Norwegian capture the fracture initiative). Osteoporos Int. Published 14 January 2025. doi:10.
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