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Aggressive treatment needed for initial fractures


Aggressive treatment needed for initial fractures

Osteoporotic refractures greatly compound the risk of death in elderly patients, underlining the need for the initial fracture to be treated early and aggressively, Australian researchers say.

People over 60 who had suffered a refracture were nearly a third more likely to die over the next five years than those who had only had one fracture, the prospective study of 1,300 people showed.

Five-year mortality for men and women with a refracture was 51% and 39% respectively, compared with 37% and 26% for a single fracture, the authors from Sydney’s Garvan Institute and the University of Notre Dame found.

Although fracture-related death was highest in the first five years after the initial fracture it remained high for a decade, with deaths in the second half almost entirely due to refracture, they said.

The mortality rate then plateaued for the 30% of patients still alive, they noted.

Writing in the Journal of Bone and Mineral Research, the authors said their study had “important clinical implications”, supporting the need for early, aggressive treatment after a first low trauma fracture to reduce risk of refracture, at least in those with low bone density.

Previous research had shown up to 50% of refractures could be prevented with anti-resorptive and other therapies, they noted.

The study cohort was a subset of men and women from the Dubbo Osteoporosis Epidemiology Study, which began in 1989 and is the world’s longest-running study into osteoporotic fractures.

Journal of Bone and Mineral Research 2013; online


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