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J Bone Miner Metab. 2018 Nov 21. doi: 10.1007/s00774-018-0974-4. [Epub ahead of print]

Re-fracture and correlated risk factors in patients with osteoporotic vertebral fractures.

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School of Nursing, Fudan University, Shanghai, 200032, China.
School of Nursing, Fudan University, Shanghai, 200032, China.
Youjiang Medical University for Nationalities, Baise, 533000, China.
West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, China.
The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, China.


Re-fracture risk is higher following osteoporotic fracture. However, there is no accurately reported rate of re-fracture incidence in southwest China. The purpose of this study was to describe the osteoporotic vertebral fracture (OVF) survival for re-fracture state and analyze the risk of re-fracture. This historical cohort study was conducted in four hospitals in southwest China. Patients aged ≥ 50 years (n = 586) with OVF who were supposed to receive anti-osteoporosis drugs after the fracture were included (2012-2017). Telephone follow-up and referring case files were used to estimate the survival for re-fracture and identify the determinants of re-fracture. A total of 555 patients completed the follow-up investigation. Overall, 285 patients experienced a re-fracture, and the longest follow-up investigation time was 72 months. The survival rates for re-fracture at 12 months, 24 months, 36 months, and 48 months were 82.0%, 71.5%, 61.7%, and 34.0%, respectively. The factors correlated with re-fracture hazard were advanced age [hazard ratio (HR) = 1.996], being female (HR = 1.342), smoking (HR = 1.435), history of hypertension (HR = 1.219) and diabetes (HR = 3.271), and persistence of taking anti-osteoporosis drugs after fracture [0-3 months, 4-6 months, 7-12 months, and more than 12 months (HR = 0.703)]. OVF patients with advanced age, who were female, smoked, had fracture with hypertension or diabetes, and who complied poorly with anti-osteoporosis drug treatment presented higher prevalence of re-fracture and low anti-osteoporosis adherence in southwest China. The management of anti-osteoporosis after fracture is necessary in this area.


Anti-osteoporosis; Osteoporosis; Osteoporotic vertebral fracture; Re-fracture


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