Osteoporosis and fracture risk - a linked data study in Wales
Introduction Osteoporosis is a global disease with a 30-40% lifetime fracture risk according to the World Health Organisation. Over half a million people receive treatment for fragility fractures annually in the UK. Osteoporosis incidence is rising with aging populations; however, medical secondary...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Swansea University
2018-08-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/684 |
| _version_ | 1797430953412395008 |
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| author | Laura North Llion Davies Damon Berridge Angharad Walters Ashley Akbari Ronan Lyons |
| author_facet | Laura North Llion Davies Damon Berridge Angharad Walters Ashley Akbari Ronan Lyons |
| author_sort | Laura North |
| collection | DOAJ |
| description | Introduction
Osteoporosis is a global disease with a 30-40% lifetime fracture risk according to the World Health Organisation. Over half a million people receive treatment for fragility fractures annually in the UK. Osteoporosis incidence is rising with aging populations; however, medical secondary prevention treatment may reduce fracture risk.
Objectives and Approach
Primary aims were to investigate if secondary medical prevention treatment following an index fracture was associated with survival and subsequent fracture risk, evaluated using a pseudonymised population based e-cohort study design. Patients aged ≥60 years with an index fragility fracture at any anatomical location were identified from the Secure Anonymised Information Linkage (SAIL) databank. Fracture data were identified from secondary care datasets (emergency department and inpatient) and the National Hip Fracture Register data. In addition linkages were made to primary care datasets for medical prescription and Office for National Statistics records for mortality, supplementing data on demographic characteristics and co-morbidity.
Results
The cohort comprised 81,252 cases between April 2009 and December 2016 of median age 78 years (range 60-109) and 22,896 (28%) males. Medical secondary prevention treatment was received by 29,393 cases (36%). Subsequent fractures were reported for 10,907 cases (14%) and 29,026 cases (36%) died during the study period. For those that received medical prevention, the subsequent fracture and mortality rates were 15% and 28% respectively compared to 12% and 31% for those that did not receive the prevention treatment. Further analyses will include a discrete time competing risks model.
Conclusion/Implications
A population based e-cohort was successfully created by linking data across multiple datasets. Preliminary findings identified that <50% of eligible patients receive secondary medical prevention treatment after an index fragility fracture. These findings may help inform and unify treatment pathways for those at risk of fragility fractures. |
| first_indexed | 2024-03-09T09:34:56Z |
| format | Article |
| id | doaj.art-850bd8e56e7f4795b1468a3ce449f63d |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T09:34:56Z |
| publishDate | 2018-08-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-850bd8e56e7f4795b1468a3ce449f63d2023-12-02T02:22:09ZengSwansea UniversityInternational Journal of Population Data Science2399-49082018-08-013410.23889/ijpds.v3i4.684Osteoporosis and fracture risk - a linked data study in WalesLaura North0Llion Davies1Damon Berridge2Angharad Walters3Ashley Akbari4Ronan Lyons5Farr Institute, Swansea University Medical SchoolPublic Health WalesFarr Institute, Swansea University Medical SchoolFarr Institute, Swansea University Medical SchoolHealth Data Research UK - Wales and Northern Ireland, Swansea University Medical SchoolFarr Institute, Swansea University Medical SchoolIntroduction Osteoporosis is a global disease with a 30-40% lifetime fracture risk according to the World Health Organisation. Over half a million people receive treatment for fragility fractures annually in the UK. Osteoporosis incidence is rising with aging populations; however, medical secondary prevention treatment may reduce fracture risk. Objectives and Approach Primary aims were to investigate if secondary medical prevention treatment following an index fracture was associated with survival and subsequent fracture risk, evaluated using a pseudonymised population based e-cohort study design. Patients aged ≥60 years with an index fragility fracture at any anatomical location were identified from the Secure Anonymised Information Linkage (SAIL) databank. Fracture data were identified from secondary care datasets (emergency department and inpatient) and the National Hip Fracture Register data. In addition linkages were made to primary care datasets for medical prescription and Office for National Statistics records for mortality, supplementing data on demographic characteristics and co-morbidity. Results The cohort comprised 81,252 cases between April 2009 and December 2016 of median age 78 years (range 60-109) and 22,896 (28%) males. Medical secondary prevention treatment was received by 29,393 cases (36%). Subsequent fractures were reported for 10,907 cases (14%) and 29,026 cases (36%) died during the study period. For those that received medical prevention, the subsequent fracture and mortality rates were 15% and 28% respectively compared to 12% and 31% for those that did not receive the prevention treatment. Further analyses will include a discrete time competing risks model. Conclusion/Implications A population based e-cohort was successfully created by linking data across multiple datasets. Preliminary findings identified that <50% of eligible patients receive secondary medical prevention treatment after an index fragility fracture. These findings may help inform and unify treatment pathways for those at risk of fragility fractures.https://ijpds.org/article/view/684 |
| spellingShingle | Laura North Llion Davies Damon Berridge Angharad Walters Ashley Akbari Ronan Lyons Osteoporosis and fracture risk - a linked data study in Wales International Journal of Population Data Science |
| title | Osteoporosis and fracture risk - a linked data study in Wales |
| title_full | Osteoporosis and fracture risk - a linked data study in Wales |
| title_fullStr | Osteoporosis and fracture risk - a linked data study in Wales |
| title_full_unstemmed | Osteoporosis and fracture risk - a linked data study in Wales |
| title_short | Osteoporosis and fracture risk - a linked data study in Wales |
| title_sort | osteoporosis and fracture risk a linked data study in wales |
| url | https://ijpds.org/article/view/684 |
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