Abstract
Study Design.Retrospective cohort study of the Own the Bone database which is a fracture liaison service designed to improve recognition and treatment of osteoporosis.Objective.To use the Own the Bone (OTB) database to 1) examine the specific demographics of patients presenting with a low-energy clinical vertebral fracture (VFX) and 2) compare demographic and fracture-specific risk factors between patients with clinical VFX versus patients with nonvertebral low-energy fracture (NVFX).Summary of Background Data.Large database studies have described risk factors for developing VFX. It is well described that a history of previous VFX portends an increased risk of future VFX. Few studies have reported cohorts from a fracture liaison service such as the OTB initiative.Methods.35,039 unique cases of fragility fracture occurred between 2009 and 2016 and were included in analysis. VFX accounted for 3395 (9.9%) of the presenting fractures at OTB enrollment. The demographics, lifestyle factors, medication use, and fracture-specific data for patients in the OTB registry with vertebral fractures were summarized and then statistically compared to those with nonvertebral fragility fractures.Results.The majority of VFX patients were Caucasian, postmenopausal women (74.4%). There was an increased likelihood of presenting with a vertebral fracture in patients who sustained a previous VFX after the age of 50, while patients who sustained a prior nonvertebral fracture (NVFX) were more likely to present with a subsequent NVFX. After controlling for patients with a history of fracture after the age of 50, VFX patients (vs. NVFX) were more likely to be age 70-79, class 1 obesity, with a history of taking anti-osteoporotic prescription medications.Conclusions.Multiple factors were associated with a significantly increased risk of VFX compared with NVFX. Understanding the risk factors unique to fragility VFX is a critical component for targeting "at-risk"patients and preventing future osteoporosis-related fractures and their consequences.Level of Evidence: 4.
| Original language | English (US) |
|---|---|
| Pages (from-to) | E430-E438 |
| Journal | Spine |
| Volume | 45 |
| Issue number | 8 |
| DOIs | |
| State | Published - Apr 15 2020 |
Funding
From the *Mayo Clinic, Rochester, MN; †Northwestern University Feinberg School of Medicine, Chicago, IL; zThe American Orthopaedic Association, Rosemont , IL; §The CORE Institute, Phoenix, AZ; {West Virginia School of Medicine, Morgantown, WV; ||University of Texas, Dell Medical School, Austin, TX; **Mercy Health, Cincinnati, OH; ††Children’s National Health System, Washington, DC; and zzUniversity of Wisconsin, Madison, WI. Acknowledgment date: May 17, 2019. First revision date: July 8, 2019. Acceptance date: September 25, 2019. The manuscript submitted does not contain information about medical device(s)/drug(s). Funding for the Own the Bone program was provided by Amgen, Eli Lilly, DePuy Synthes, Orthovita, Merck, Novartis, Radius Health, and Warner Chilcott. Relevant financial activities outside the submitted work: board membership, consultancy, royalties, stocks, employment, payment for lecture. Address correspondence and reprint requests to Brett A. Freedman, MD, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; E-mail: [email protected]
Keywords
- Own the Bone
- insufficiency fracture
- osteoporosis
- vertebral fragility fracture
ASJC Scopus subject areas
- Clinical Neurology
- Orthopedics and Sports Medicine
