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. 2021 Jun;32(6):1093-1101.
doi: 10.1007/s00198-020-05772-8. Epub 2021 Jan 7.

Risk factors for imminent fractures: a substudy of the FRISBEE cohort

L Iconaru  1 , M Moreau  2 , F Baleanu  3 , V Kinnard  4 , A Charles  5 , A Mugisha  4 , M Surquin  4 , F Benoit  4 , R Karmali  3 , M Paesmans  2 , J J Body  3   5 , P Bergmann  5   6
Affiliations

Risk factors for imminent fractures: a substudy of the FRISBEE cohort

L Iconaru et al. Osteoporos Int. 2021 Jun.

Abstract

Multiple factors increase the risk of an imminent fracture, including a recent fracture, older age, osteoporosis, comorbidities, and the fracture site. These findings could be a first step in the development of a model to predict an imminent fracture and select patients most at need of immediate treatment.

Introduction: The risk of a recurrent fragility fracture is maximal during the first 2 years following an incident fracture. In this prospective cohort study, we looked at the incidence of recurrent fractures within 2 years after a first incident fracture and we assessed independent clinical risk factors (CRFs) increasing this imminent fracture risk.

Methods: A total of 3560 postmenopausal women recruited from 2007 to 2013 were surveyed yearly for the occurrence of fragility fractures. We identified patients who sustained a fracture during the first 2 years following a first incident fragility fracture. We quantified the risk of a new fracture and assessed independent CRFs, associated with an imminent fracture at various sites.

Results: A recent fracture was a significant CRF for an imminent fracture (OR (95% CI): 3.7 (2.4-5.7) [p < 0.0001]). The incidence of an imminent fracture was higher in subjects above 80 years (p < 0.001). Other CRFs highly predictive in a multivariate analysis were osteoporosis diagnosis (p < 0.01), a central fracture as the index fracture (p < 0.01), and the presence of comorbidities (p < 0.05), with likelihood ratios of 1.9, 1.9, and 2.2, respectively. An imminent fracture was better predicted by a central fracture (p < 0.01) than by a major osteoporotic fracture. The hazard ratio was the highest for a central fracture.

Conclusion: In patients with a recent fracture, older age, osteoporosis, comorbidities, and fracture site were associated with an imminent fracture risk. These findings could be a first step in the development of a model to predict an imminent fracture and select patients most at need of immediate and most appropriate treatment.

Keywords: Clinical risk factors; Imminent fracture.

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