Research presented today at the 4th Asia-Pacific Osteoporosis Meeting showed that second hip fractures are more deadly than first hip fractures. Based in Hong Kong, the study evaluated the overall incidence of a second hip fracture and subsequent mortality in 43,832 patients, aged 65 or above, with operatively treated first hip fracture during the years 2000-2011. The patients’ mean age was 82±7.38 and the male to female ratio was 3:7. A total of 2,399 second hip fractures were identified.
On average, second hip fractures occurred 2 years and 8 months after the primary hip fracture. Females had a higher incidence of second hip fracture. The overall incidence of a second fracture was 0.88% at 6 months, 1.81% at 1 year, 6.91% at 5 years and 9.95% at 10 years. A total 75% of second fractures occurred within around 4 years after the initial fracture.
The median survival after single fracture was 4 years 10 months, while second fracture was 3 years 8 months. Lower survival was observed in second fracture (HR 5.44, 95%CI 1.67-11.1, p<0.001) and in males (HR 1.91, 95%CI 1.86-1.96, p<0.05). Older patients had a minimal risk for increase mortality (HR 1.061, 95%CI 1.059-1.063, p<0.05).
The authors concluded that further studies are needed to help explain the excessive mortality of second hip fracture compared to primary hip fractures. Furthermore, they suggest that early initiation of treatment and a fragility fracture prevention programme after primary hip fracture could help reduce second fracture incidence and related mortality.
Abstract OC 16: Second hip fracture in Hong Kong Chinese: incidence, epidemiology and mortality. Osteoporos Int, Vol. 2, Suppl. 4, DOI 10.1007/s00198-013-2536-x
The International Osteoporosis Foundation (IOF) is the world’s largest nongovernmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF leads World Osteoporosis Day marked on October 20 each year. IOF members, including committees of scientific researchers, leading companies, as well as more than 200 patient, medical and research societies, work together to make bone, joint and muscle health a worldwide heath care priority.
About Capture the Fracture
Capture the Fracture is a multi-stakeholder global initiative, which seeks to reduce secondary fractures worldwide. It promotes the implementation of coordinator-based, post-fracture models of care called Fracture Liaison Services (FLS). FLS aid health-care professionals to identify a patient who has had a first fracture, test for osteoporosis and provide the necessary treatment to prevent subsequent fractures. Capture the Fracture was launched by the IOF in 2012 and helps: raise awareness of FLS for preventing second fractures; provide internationally endorsed standards for best practice; facilitate change at a national level.
Charanjit K. Jagait, Ph.D.
International Osteoporosis Foundation