Evidence map›Paper›PMID 31152183›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019

Five-year refracture rates of a province-wide fracture liaison service.

R Sujic, D E Beaton, M Mamdani, S M Cadarette, J Luo, S Jaglal, J E M Sale, R Jain, E Bogoch, Ontario Osteoporosis Strategy Fracture Screening and Prevention Program Evaluation Team

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Pooled it
  3. A systemwide approach to secondary fracture prevention-the New South Wales Osteoporosis Refracture Prevention Initiative was associated with reduced refractures and was economically sustainable.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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  6. Epidemiology of osteoporotic ankle fractures in South Korea: a nationwide retrospective cohort study (2006-2022).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

R SujicMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada. sujicr@smh.ca.ORCID http://orcid.org/0000-0001-6507-5132
D E BeatonMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
M MamdaniInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
S M CadaretteInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
J LuoInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
S JaglalInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
J E M SaleMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
R JainOntario Osteoporosis Strategy, Osteoporosis Canada, Toronto, ON, Canada.
E BogochDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Ontario Osteoporosis Strategy Fracture Screening and Prevention Program Evaluation Team
St. Michael's Hospital · CAUniversity of Toronto · CAInstitute for Clinical Evaluative Sciences · CAUniversity Health Network · CA

Funding

Ontario Ministry of Health and Long-Term Care N/A
6 · The paper itself

Abstract

We examined the 5-year refracture rate of 6543 patients and found an overall rate of 9.7%. Adjusted analysis showed that presenting with multiple fractures was an indicator of a higher refracture risk; while presenting with an ankle fracture was associated with a lower refracture risk.

introductionTo examine refractures among patients screened in a province-wide fracture liaison service (FLS).

methodsWe assessed the 5-year refracture rate of fragility fracture patients aged 50+ who were screened at 37 FLS fracture clinics in Ontario, Canada. Refracture was defined as a new hip, pelvis, spine, distal radius, or proximal humerus fracture. Kaplan-Meier curves and Cox proportional hazards model adjusting for age, sex, and index fracture type were used to examine refracture rates.

resultsThe 5-year refracture rate of 6543 patients was 9.7%. Those presenting with multiple fractures at baseline (i.e., two or more fractures occurring simultaneously) had the highest refracture rate of 19.6%. As compared to the 50-65 age group, refracture risk increased monotonically with age group (66-70 years: HR = 1.3, CI 95%, 1.0-1.7; 71-80 years: HR = 1.7, CI 1.4-2.1; 81+ years: HR = 3.0, CI 2.4-3.7). Relative to distal radius, presenting with multiple fractures at screening was associated with a higher risk of refracture (HR = 2.3 CI 1.6-3.1), while presenting with an ankle fracture was associated with a lower risk of refracture (HR = 0.7 CI 0.6-0.9). Sex was not a statistically significant predictor of refracture risk in this cohort (HR = 1.2, CI 1.0-1.5).

conclusionsOne in ten patients in our cohort refractured within 5 years after baseline. Presenting with multiple fractures was an indicator of a higher refracture risk, while presenting with an ankle fracture was associated with a lower refracture risk. A more targeted FLS approach may be appropriate for patients at a higher refracture risk.

Indexed as

AgedAged, 80 and overAge DistributionAnkle FracturesFemaleFollow-Up StudiesFractures, MultipleHumansKaplan-Meier EstimateMaleMass ScreeningMiddle AgedOntarioOsteoporotic FracturesRecurrenceRisk AssessmentFracture liaison serviceFragility fractureRefracture ratesRefracture risk

Identifiers

PMID31152183
OpenAlexW2947073998

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.