Searchable abstracts of presentations at key conferences on calcified tissues
Bone Abstracts (2014) 3 OC2.6 | DOI: 10.1530/boneabs.3.OC2.6

Osteoporosis epidemiology

Absolute fracture and mortality risk in patients with a recent non-vertebral fracture: the contribution of secondary osteoporosis or other metabolic bone disease (SECOB)

Tineke van Geel1, Piet Geusens2,3, Sandrine Bours2, Caroline Wyers2,4 & Joop van den Bergh2,4


1Dept. of Family Medicine, Maastricht University, Maastricht, The Netherlands; 2Dept. of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands; 3University Hasselt, Biomedical Research Institute, Hasselt, Belgium; 4VieCuri Medical Centre, Venlo, The Netherlands.

Objective: To investigate whether patients with secondary osteoporosis or other metabolic bone disease (SECOB) have a higher re-fracture or mortality risk.

Method: Patients with a recent non-vertebral fracture who visited the Fracture Liaison Service (FLS) of a hospital were prospectively followed for 2 years. Pearson Chi-square, Fisher’s Exact test, independent samples T-test, and Cox regression models were used.

Results: In total, 713 patients were invited to attend the FLS, and 510 attended (78.4% women). Of the 510 patients, 179 (35.1%) had osteoporosis, 251 (49.2%) were osteopenic, and 80 (15.7%) had normal bone mineral density (BMD). In total, 215 patients (42.2%) had known or newly diagnosed SECOB (77.7% women). Patients with SECOB were significantly older (68.9 vs 64.4 years, P<0.001) had lower BMD (T-score: −2.3 vs −1.9, P<0.001), were prescribed more bisphosphonates or PTH (53.6 vs 46.4%, P<0.001) and sustained more initial hip fractures (57.4% vs 42.6%, P=0.042) than patients without SECOB. Gender (women: 41.8 vs 43.6%, P=0.723) was not significantly different.

In total, 37 patients (7.3%) re-fractured and 15 (3.0%) died within 2 years of follow-up. The absolute re-fracture risk was not significantly different between patients with or without SECOB (8.8 vs 6.1%, P=0.240; relative risk (RR): 1.2). However, absolute mortality risk was significantly different (6.1 vs 0.70%, P=0.001; RR: 8.9). Although the numbers of events are small (<10%), Cox models showed similar results: no significant differences for re-fracture risk, but age-adjusted mortality risk was significantly higher for patients with SECOB (hazard ratio: 7.0, 1.6–31.8).

Conclusion: Two out of five patients, who attend the FLS because of a recent fracture, had SECOB. Absolute re-fracture risk is similar between patients with or without SECOB, but mortality risk is substantially higher in patients with SECOB.

Volume 3

European Calcified Tissue Society Congress 2014

Prague, Czech Republic
17 May 2014 - 20 May 2014

European Calcified Tissue Society 

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