Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.

Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporo...

Full description

Bibliographic Details
Main Authors: Gehlbach, S, Saag, K, Adachi, J, Hooven, F, Flahive, J, Boonen, S, Chapurlat, R, Compston, J, Cooper, C, Díez-Perez, A, Greenspan, S, LaCroix, A, Netelenbos, J, Pfeilschifter, J, Rossini, M, Roux, C, Sambrook, P, Silverman, S, Siris, E, Watts, N, Lindsay, R
Format: Journal article
Language:English
Published: 2012
_version_ 1797104215000088576
author Gehlbach, S
Saag, K
Adachi, J
Hooven, F
Flahive, J
Boonen, S
Chapurlat, R
Compston, J
Cooper, C
Díez-Perez, A
Greenspan, S
LaCroix, A
Netelenbos, J
Pfeilschifter, J
Rossini, M
Roux, C
Sambrook, P
Silverman, S
Siris, E
Watts, N
Lindsay, R
author_facet Gehlbach, S
Saag, K
Adachi, J
Hooven, F
Flahive, J
Boonen, S
Chapurlat, R
Compston, J
Cooper, C
Díez-Perez, A
Greenspan, S
LaCroix, A
Netelenbos, J
Pfeilschifter, J
Rossini, M
Roux, C
Sambrook, P
Silverman, S
Siris, E
Watts, N
Lindsay, R
author_sort Gehlbach, S
collection OXFORD
description Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women aged ≥55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures, respectively, since age 45 years. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no previous fractures, women with 1, 2, or ≥3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio [HR] = 7.3) and hip (HR = 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, and previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture. Women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development.
first_indexed 2024-03-07T06:30:43Z
format Journal article
id oxford-uuid:f5e572e1-652c-4ada-a3db-2d31cc400071
institution University of Oxford
language English
last_indexed 2024-03-07T06:30:43Z
publishDate 2012
record_format dspace
spelling oxford-uuid:f5e572e1-652c-4ada-a3db-2d31cc4000712022-03-27T12:30:53ZPrevious fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f5e572e1-652c-4ada-a3db-2d31cc400071EnglishSymplectic Elements at Oxford2012Gehlbach, SSaag, KAdachi, JHooven, FFlahive, JBoonen, SChapurlat, RCompston, JCooper, CDíez-Perez, AGreenspan, SLaCroix, ANetelenbos, JPfeilschifter, JRossini, MRoux, CSambrook, PSilverman, SSiris, EWatts, NLindsay, RPrevious fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women aged ≥55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures, respectively, since age 45 years. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no previous fractures, women with 1, 2, or ≥3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio [HR] = 7.3) and hip (HR = 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, and previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture. Women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development.
spellingShingle Gehlbach, S
Saag, K
Adachi, J
Hooven, F
Flahive, J
Boonen, S
Chapurlat, R
Compston, J
Cooper, C
Díez-Perez, A
Greenspan, S
LaCroix, A
Netelenbos, J
Pfeilschifter, J
Rossini, M
Roux, C
Sambrook, P
Silverman, S
Siris, E
Watts, N
Lindsay, R
Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title_full Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title_fullStr Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title_full_unstemmed Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title_short Previous fractures at multiple sites increase the risk for subsequent fractures: the Global Longitudinal Study of Osteoporosis in Women.
title_sort previous fractures at multiple sites increase the risk for subsequent fractures the global longitudinal study of osteoporosis in women
work_keys_str_mv AT gehlbachs previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT saagk previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT adachij previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT hoovenf previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT flahivej previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT boonens previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT chapurlatr previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT compstonj previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT cooperc previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT diezpereza previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT greenspans previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT lacroixa previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT netelenbosj previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT pfeilschifterj previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT rossinim previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT rouxc previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT sambrookp previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT silvermans previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT sirise previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT wattsn previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen
AT lindsayr previousfracturesatmultiplesitesincreasetheriskforsubsequentfracturesthegloballongitudinalstudyofosteoporosisinwomen