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Previous Fracture and Subsequent Fracture Risk: A Meta-Analysis to Update Frax Publisher Pubmed



Kanis JA1, 2 ; Johansson H1, 3 ; Mccloskey EV2, 4 ; Liu E1 ; Akesson KE5, 6 ; Anderson FA7 ; Azagra R8, 9, 10 ; Bager CL11 ; Beaudart C12, 13 ; Bischoffferrari HA14, 15 ; Biver E16 ; Bruyere O12 ; Cauley JA17 ; Center JR18, 19, 20 Show All Authors
Authors
  1. Kanis JA1, 2
  2. Johansson H1, 3
  3. Mccloskey EV2, 4
  4. Liu E1
  5. Akesson KE5, 6
  6. Anderson FA7
  7. Azagra R8, 9, 10
  8. Bager CL11
  9. Beaudart C12, 13
  10. Bischoffferrari HA14, 15
  11. Biver E16
  12. Bruyere O12
  13. Cauley JA17
  14. Center JR18, 19, 20
  15. Chapurlat R21
  16. Christiansen C11
  17. Cooper C22, 23, 24
  18. Crandall CJ25
  19. Cummings SR26
  20. Da Silva JAP27, 28
  21. Dawsonhughes B29
  22. Diezperez A30
  23. Dufour AB31, 32
  24. Eisman JA18, 19, 20
  25. Elders PJM33
  26. Ferrari S16
  27. Fujita Y34
  28. Fujiwara S35
  29. Gluer CC36
  30. Goldshtein I37, 38
  31. Goltzman D39
  32. Gudnason V40, 41
  33. Hall J42
  34. Hans D43
  35. Hoff M44, 45
  36. Hollick RJ46
  37. Huisman M47, 48
  38. Iki M49
  39. Ishshalom S50
  40. Jones G51
  41. Karlsson MK5, 6
  42. Khosla S52
  43. Kiel DP31, 32
  44. Koh WP53, 54
  45. Koromani F55, 56
  46. Kotowicz MA57, 58, 59
  47. Kroger H60, 61
  48. Kwok T62, 63
  49. Lamy O64, 65
  50. Langhammer A66
  51. Larijani B67
  52. Lippuner K68
  53. Mellstrom D69, 70
  54. Merlijn T71
  55. Nordstrom A72, 73, 74
  56. Nordstrom P75
  57. Oneill TW76, 77
  58. Obermayerpietsch B78, 79
  59. Ohlsson C80, 81
  60. Orwoll ES82
  61. Pasco JA57, 58, 59, 83
  62. Rivadeneira F55
  63. Schott AM84
  64. Shiroma EJ85
  65. Siggeirsdottir K40, 86
  66. Simonsick EM87
  67. Sornayrendu E88
  68. Sund R61
  69. Swart KMA33, 89
  70. Szulc P88
  71. Tamaki J90
  72. Torgerson DJ91
  73. Van Schoor NM47
  74. Van Staa TP92
  75. Vila J93
  76. Wareham NJ94
  77. Wright NC95
  78. Yoshimura N96
  79. Zillikens MC55
  80. Zwart M10, 97, 98, 99
  81. Vandenput L1, 80
  82. Harvey NC22, 23
  83. Lorentzon M1, 3
  84. Leslie WD100
Show Affiliations
Authors Affiliations
  1. 1. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
  2. 2. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom
  3. 3. Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
  4. 4. MRC Versus Arthritis Centre for Integrated research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, United Kingdom
  5. 5. Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
  6. 6. Department of Orthopedics, Skane University Hospital, Malmo, Sweden
  7. 7. GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, United States
  8. 8. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
  9. 9. Health Centre Badia del Valles, Catalan Institute of Health, Barcelona, Spain
  10. 10. PRECIOSA-Fundacion para la investigacion, Barbera del Valles, Barcelona, Spain
  11. 11. Nordic Bioscience A/S, Herlev, Denmark
  12. 12. WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
  13. 13. Department of Health Services Research, University of Maastricht, Maastricht, Netherlands
  14. 14. Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland
  15. 15. Centre on Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland
  16. 16. Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
  17. 17. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, United States
  18. 18. Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia
  19. 19. St Vincent’s Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia
  20. 20. School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia
  21. 21. INSERM UMR 1033, Universite Claude Bernard-Lyon1, Hopital Edouard Herriot, Lyon, France
  22. 22. MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
  23. 23. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
  24. 24. NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, United Kingdom
  25. 25. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  26. 26. San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, United States
  27. 27. Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  28. 28. Rheumatology Department, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
  29. 29. Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
  30. 30. Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain
  31. 31. Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, United States
  32. 32. Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
  33. 33. Petra JM Elders Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  34. 34. Center for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka, Japan
  35. 35. Department of Pharmacy, Yasuda Women’s University, Hiroshima, Japan
  36. 36. Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
  37. 37. Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
  38. 38. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  39. 39. Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada
  40. 40. Icelandic Heart Association, Kopavogur, Iceland
  41. 41. University of Iceland, Reykjavik, Iceland
  42. 42. MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
  43. 43. Interdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland
  44. 44. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
  45. 45. Department of Rheumatology, St Olavs Hospital, Trondheim, Norway
  46. 46. Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, United Kingdom
  47. 47. Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
  48. 48. Department of Sociology, VU University, Amsterdam, Netherlands
  49. 49. Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
  50. 50. Endocrine Clinic, Elisha Hospital, Haifa, Israel
  51. 51. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
  52. 52. Robert and Arlene Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, United States
  53. 53. Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  54. 54. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
  55. 55. Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
  56. 56. Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
  57. 57. IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia
  58. 58. Barwon Health, Geelong, VIC, Australia
  59. 59. Department of Medicine -Western Health, The University of Melbourne, St Albans, VIC, Australia
  60. 60. Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
  61. 61. Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
  62. 62. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  63. 63. Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
  64. 64. Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
  65. 65. Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
  66. 66. HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
  67. 67. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  68. 68. Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland
  69. 69. Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  70. 70. Geriatric Medicine, Sahlgrenska University Hospital Molndal, Molndal, Sweden
  71. 71. Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  72. 72. School of Sport Sciences, UiT The Arctic University of Norway, Tromso, Norway
  73. 73. Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Ostersund, Sweden
  74. 74. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  75. 75. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
  76. 76. National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
  77. 77. Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, United Kingdom
  78. 78. Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
  79. 79. Center for Biomarker Research in Medicine, Graz, Austria
  80. 80. Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  81. 81. Department of Drug Treatment, Sahlgrenska University Hospital, Region Vastra Gotaland, Gothenburg, Sweden
  82. 82. Department of Medicine, Oregon Health and Science University, Portland, OR, United States
  83. 83. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  84. 84. Universite Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France
  85. 85. Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, United States
  86. 86. Janus Rehabilitation, Reykjavik, Iceland
  87. 87. Translational Gerontology Branch, National Institute on Aging Intramural Research Program, Baltimore, MD, United States
  88. 88. INSERM UMR 1033, University of Lyon, Hopital Edouard Herriot, Lyon, France
  89. 89. PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands
  90. 90. Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan
  91. 91. York Trials Unit, Department of Health Sciences, University of York, York, United Kingdom
  92. 92. Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
  93. 93. Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
  94. 94. MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
  95. 95. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
  96. 96. Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan
  97. 97. Health Center Can Gibert del Pla, Catalan Institute of Health, Girona, Spain
  98. 98. Department of Medical Sciences, University of Girona, Girona, Spain
  99. 99. GROIMAP/GROICAP (research groups), Unitat de Suport a la Recerca Girona, Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol, Girona, Spain
  100. 100. Department of Medicine, University of Manitoba, Winnipeg, MB, Canada

Source: Osteoporosis International Published:2023


Abstract

Summary: A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX. Introduction: The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD). Methods: We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients. Results: A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72–2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69–2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63–2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62–2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination. 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. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies. © 2023, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
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