SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2023
Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
Open access · greenAbstract readMeta-Analysis
In one paragraph
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 7 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 7 pooled it
17.6field-weighted citation impact, top 1% of its field
What it found
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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.
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.
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Who cites it
60 citing papers in PubMed, 7 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Predictive value of BMD for hip and other fractures: a meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Pooled it
- The Anabolic-First Strategy in Osteoporosis: A Systematic Review and Meta-Analysis of Fracture Outcomes in Patients at Very High Fracture Risk.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Risk factors for vertebral fractures in postmenopausal women: a meta-analysis.Frontiers in medicine · 2026Pooled it
- Body mass index and subsequent fracture risk: a meta-analysis to update FRAX.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Pooled it
- Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- Updated practice guideline for dual-energy X-ray absorptiometry (DXA).European journal of nuclear medicine and molecular imaging · 2025Guideline
- Association between a history of major osteoporotic fractures and subsequent hip fracture: a systematic review and meta-analysis.Archives of osteoporosis · 2024Pooled it
- Impact of FRAXplus adjustments vs FRAX on fracture risk classification in the Swiss Osteoporosis Registry.JBMR plus · 2026Article
- A territorially coordinated, eHealth-supported fracture liaison service following femur fragility fracture: a pilot randomised controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Demographic and clinical differences between individuals with and without DXA scans in Denmark.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Fragility fractures and risk factors in a peritoneal dialysis setting.Archives of osteoporosis · 2026Article
- Injury-driven stromal exhaustion disrupts intrinsic regenerative capability.Nature communications · 2026Article
- Preoperative vertebral fracture assessment reveals bone fragility missed by DXA in patients undergoing total hip arthroplasty.Arthroplasty (London, England) · 2026Article
- Association of implementation of secondary fracture prevention incentives after hip fracture and risk of subsequent fracture in real-world practice.European geriatric medicine · 2026Article
- The hidden fracture: a retrospective study of fragility vertebral fracture in patients with hip fracture.Archives of osteoporosis · 2026Article
- Impact of In-Hospital Osteoporosis Treatment on Post-discharge Medication Continuity in Osteoporotic Fracture Patients: Implications for Care Continuity.Clinics in orthopedic surgery · 2026Article
- Midlife risk factors predict long-term hip fracture risk in women: a 35-yr follow-up.JBMR plus · 2026Article
- Benchmarking Time-Series Artificial Intelligence Architectures for Wearable Sensor-Based Fall Prediction: A Synthetic Data Simulation Framework.Sensors (Basel, Switzerland) · 2026Article
- The CKD-OSTEO Score: A Chronic Kidney Disease-specific Tool for Osteoporosis Risk Stratification.TouchREVIEWS in endocrinology · 2026Review
- Osteoporosis in rheumatoid arthritis: a new perspective on risk factors and clinical prediction models.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
84 authors at 20 institutions in 23 countries.
J A KanisMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@sheffield.ac.uk.ORCID http://orcid.org/0000-0002-3129-4326
H JohanssonMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
E V McCloskeyCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
E LiuMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
K E ÅkessonClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
F A AndersonGLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
R AzagraDepartment of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
C L BagerNordic Bioscience A/S, Herlev, Denmark.
C BeaudartWHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
H A Bischoff-FerrariDepartment of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland.
E BiverDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
O BruyèreWHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
J A CauleyDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, USA.
J R CenterSkeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia.
R ChapurlatINSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France.
C ChristiansenNordic Bioscience A/S, Herlev, Denmark.
C CooperMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
C J CrandallDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
S R CummingsSan Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
J A P da SilvaCoimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
B Dawson-HughesBone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
A Diez-PerezDepartment of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain.
A B DufourMarcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
J A EismanSkeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia.
P J M EldersPetra JM Elders Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
S FerrariDivision of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Y FujitaCenter for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka, Japan.
S FujiwaraDepartment of Pharmacy, Yasuda Women's University, Hiroshima, Japan.
C-C GlüerSection Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany.
I GoldshteinMaccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
D GoltzmanDepartment of Medicine, McGill University and McGill University Health Centre, Montreal, Canada.
V GudnasonIcelandic Heart Association, Kopavogur, Iceland.
J HallMRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
D HansInterdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
M HoffDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
R J HollickAberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK.
M HuismanDepartment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
M IkiDepartment of Public Health, Kindai University Faculty of Medicine, Osaka, Japan.
S Ish-ShalomEndocrine Clinic, Elisha Hospital, Haifa, Israel.
G JonesMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
M K KarlssonClinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
S KhoslaRobert and Arlene Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
D P KielMarcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
W-P KohHealthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
F KoromaniDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
M A KotowiczIMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Victoria, Australia.
H KrögerDepartment of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland.
T KwokDepartment of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
O LamyCentre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
A LanghammerHUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
B LarijaniEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
K LippunerDepartment of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland.
D MellströmGeriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
T MerlijnDepartment of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
A NordströmSchool of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
P NordströmDepartment of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
T W O'NeillNational Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
B Obermayer-PietschDepartment of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
C OhlssonSahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
E S OrwollDepartment of Medicine, Oregon Health and Science University, Portland, OR, USA.
J A PascoIMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Victoria, Australia.
F RivadeneiraDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
A-M SchottUniversité Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France.
E J ShiromaLaboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA.
K SiggeirsdottirIcelandic Heart Association, Kopavogur, Iceland.
E M SimonsickTranslational Gerontology Branch, National Institute on Aging Intramural Research Program, Baltimore, MD, USA.
E Sornay-RenduINSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
R SundKuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland.
K M A SwartPetra JM Elders Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
P SzulcINSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
J TamakiDepartment of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan.
D J TorgersonYork Trials Unit, Department of Health Sciences, University of York, York, UK.
N M van SchoorDepartment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
T P van StaaCentre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.
J VilaStatistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
N J WarehamMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
N C WrightDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
N YoshimuraDepartment of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan.
M C ZillikensDepartment of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
M ZwartPRECIOSA-Fundación para la investigación, Barberà del Vallés, Barcelona, Spain.
L VandenputMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
N C HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
M LorentzonMary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
W D LeslieDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Université Claude Bernard Lyon 1 · FRAustralian Catholic University · AUNorwegian University of Science and Technology · NOUppsala University · SEBarwon Health · AUChinese University of Hong Kong · HKDeakin University · AUManchester Academic Health Science Centre · GBMedical University of Graz · ATMRC Centre for Reproductive Health · GBNational Institute on Aging · USNIHR Southampton Biomedical Research Centre · GBTufts University · USUniversitat Autònoma de Barcelona · ESUniversity of Aberdeen · GBUniversity of Bern · CHUniversity of California, Los Angeles · USUniversity of Cambridge · GBUniversity of Geneva · CHUniversity of Liège · BE
Funding
Oregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4MWOMEN'S HEALTH INITIATIVE - CLINICAL COORDINATING CENTER: TASK AREA B - LONG LIFE STUDY VISIT 2 LIMITED HOME VISIT75N92021D00001 · NHLBI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ANDERSON, GARNET L. · 2021 to 2025
$52.0MWOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC): TASK AREA A AND A275N92021D00002 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI WACTAWSKI-WENDE, JEAN · 2021 to 2025
$6.9MWOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00004 · NHLBI · STANFORD UNIVERSITY · PI STEFANICK, MARCIA · 2021 to 2025
$6.5MWOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00003 · NHLBI · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA · 2021 to 2025
$5.0MWOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC) - TO EXERCISE OPTION PERIOD ONE (1) AND REVISE CONTRACT ARTICLES.75N92021D00005 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI VITOLINS, MARA · 2021 to 2025
$4.2MMedical Research Council G0400491Medical Research Council G0601019Medical Research Council MC_PC_21000Medical Research Council MC_PC_21001Medical Research Council MC_PC_21003Medical Research Council MC_PC_21022Medical Research Council MC_PC_21036Medical Research Council MC_U147585819Medical Research Council MC_U147585824Medical Research Council MC_U147585827Medical Research Council MC_UP_A620_1014Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_00006/1Medical Research Council MC_UU_12011/1Medical Research Council MC_UU_12011/2Medical Research Council MR/J000094/1Medical Research Council MR/P020941/1NCATS NIH HHS UL1 TR002369NHLBI NIH HHS 75N92021D00001NHLBI NIH HHS 75N92021D00002WHI NIH HHS 75N92021D00003WHI NIH HHS 75N92021D00004WHI NIH HHS 75N92021D00005
Abstract
A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX.
introductionThe aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD).
methodsWe studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients.
resultsA previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination.
conclusionA previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
Indexed as
Hip FracturesOsteoporosisOsteoporotic FracturesBone DensityFemaleHumansMaleRisk AssessmentRisk FactorsHip fractureMajor osteoporotic fractureMeta-analysisOsteoporotic fracturePrior fracture
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