Evidence map›Paper›PMID 31720710›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020

Multiple simultaneous fractures are associated with higher all-cause mortality: results from a province-wide fracture liaison service.

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

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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, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. 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
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  7. How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Review
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

9 authors.

R SujicMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada. sujicr@smh.ca.ORCID http://orcid.org/0000-0001-6507-5132
J LuoICES, Toronto, Ontario, Canada.
D E BeatonMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
E R BogochDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
J E M SaleMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
S JaglalICES, Toronto, Ontario, Canada.
R JainOntario Osteoporosis Strategy, Osteoporosis Canada, Toronto, Ontario, Canada.
M MamdaniICES, Toronto, Ontario, Canada.
Ontario Osteoporosis Strategy Fracture Screening and Prevention Program Evaluation Team

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mortality rates in our fracture liaison service ranged from 2.7% at year 1 to 14.8% at year 5 post-screening. Presentation with multiple simultaneous fractures at screening was associated with higher risk of death. This finding indicates the need for increased focus on this high-risk group. PURPOSE: To examine all-cause mortality rates in a provincial fracture liaison service (FLS) and the association between the index fracture type, particularly multiple simultaneous fractures, and the risk of death at follow-up.

methodsThis cohort study includes fragility fracture patients aged 50+, enrolled in a provincial FLS in Ontario, Canada, between 2007 and 2010. All-cause mortality was assessed using administrative data. Multivariable Cox proportional hazards model was used to examine the risk of death 5 years after screening.

resultsCrude mortality rates for 6543 fragility fracture patients were 2.7% at year 1, 5.6% at year 2, and 14.8% at year 5 after screening. After adjusting for age and sex, and relative to distal radius fracture, patients with multiple (simultaneous) fractures at screening had a higher risk of dying (HR = 1.8, 95%CI 1.3-2.4), followed by those with a hip fracture (HR = 1.5, 95%CI 1.3-1.8), a proximal humerus fracture (HR = 1.4, 95%CI 1.2-1.7), and other single fractures (HR = 1.4, 95%CI 1.1-1.7). Having an index ankle fracture was not associated with the risk of death over a distal radius fracture. As compared to the 50-65 age group, patients 66 years and older had a higher risk of death (for 66-70 age group: HR = 2.5, 95%CI 1.9-3.3; for 71-80: HR = 4.3, 95%CI 3.5-5.4; and for 81+: HR = 10.6, 95%CI 8.7-13.0). Females had a lower risk of death (HR = 0.5, 95%CI 0.5-0.6) than males.

conclusionsPresenting with multiple fractures was an indicator of higher risk of death relative to a distal radius fracture. This finding indicates the need for increased focus on this high-risk group.

Indexed as

Fractures, MultipleHip FracturesOsteoporotic FracturesAgedCohort StudiesFemaleHumansMaleMiddle AgedOntarioProportional Hazards ModelsRisk FactorsFracture liaison serviceFragility fractureMortality ratesMultiple fracturesRisk of death

Identifiers

PMID31720710

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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.