History of Falls May Predict Patients’ Fracture Risk

Man who has fallen off of a bicycle in the snowA study led by a team of researchers at Southampton General Hospital in the United Kingdom explored the role that patients’ previous history of falls, along with other factors, played in their risk of incident fractures.

The study, “Clinical risk factors, bone density and fall history in the prediction of incident fracture among men and women,” was published online ahead of print in November 2012. It appears in the journal Bone.

According to the researchers, the FRAX algorithm commonly used to predict fracture risk uses clinical risk factors and bone mineral density information; however, it does not include patients’ falls history. To add a history of falls into the equation, the researchers utilized data from the Hertfordshire Cohort Study. They examined 2,299 patients who had completed a health questionnaire and provided anthropometric data at baseline.

Follow-ups were conducted with patients at a mean of 5.5 years after the initial assessment. The participants were sent a postal questionnaire that asked them to describe their history of falls and fractures since the baseline questionnaire. Additionally, bone densitometry was performed on a subset of 407 women and 368 men in the study.

The results of the study showed that there was a significant increase in fracture risk in participants who had sustained a previous fracture. Additionally, patients who had sustained a fall after the age of 45 had a heightened fracture risk (7.31 hazard ratio for men and 8.56 for women).

The researchers conclude that a patient’s history of falls is an independent risk factor for future fractures. They argue that this is important because a patient’s falls risk should be considered when they present for medical care. The study authors state that physicians considering whether or not to start a patient on osteoporosis medications should also consider ways to lower patients’ falls risk.

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