Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX
Pooled result · Any clinical fractureResult — go to the resultHazard ratio 1.88 95% CI 1.72–2.07Authors' conclusion
A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women.
Study context
- Population
- 665,971 men and 1,438,535 women from 64 cohorts in 32 countries; 19.5 million person-years64 cohorts · 32 countries
- Comparison
- Previous fracture history vs no prior fracture
- Outcome
- Risk of any clinical fracture (also osteoporotic, major osteoporotic and hip fracture) associated with prior fracture
Methodological detailsinternational, primary data from 64 cohorts, extended Poisson model in each cohort, results merged using weighted β-coefficients
- International
- Primary data from 64 cohorts
- Extended Poisson model in each cohort
- Results merged using weighted β-coefficients
Pooled result
Any clinical fracture
Hazard ratio
1.88
95% CI 1.72–2.07
Prior fracturevs No prior fracture
HR 1.88 (95% CI 1.72–2.07)
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| Osteoporotic fracture | 1.87 (1.69–2.07) | |
| Major osteoporotic fracture | 1.83 (1.63–2.06) | |
| Hip fracture | 1.82 (1.62–2.06) | |
| 0.512Hazard ratio (log scale) |
Risk ratio, men vs women
- No significant difference in risk ratio between men and women
Proportion of risk explained by low BMD
- Any clinical fracture
- 14%
- Osteoporotic fracture
- 17%
- Hip fracture
- 33%
- Subsequent fracture risk marginally downward adjusted when BMD taken into account
Adjustment for age and time since baseline
- Risk ratio for all fracture outcomes decreased significantly with adjustment for age and time since baseline
Original publication
Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX. Osteoporos Int. Published 11 August 2023. doi:10. 1007/ s00198-023-06870-z
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