J Bone Metab.  2019 Nov;26(4):263-270. 10.11005/jbm.2019.26.4.263.

Clinical Characteristics of Primary and Secondary Osteoporotic Fractures: Data from Single Referral Center Emergency Department

• Choi JY
• Park SM

• KMID: 2465028
• DOI: http://doi.org/10.11005/jbm.2019.26.4.263

Abstract

BACKGROUND
To investigate the characteristics of patients with osteoporotic fractures (OF) who visited the emergency room, we analyzed the frequency and distribution of primary and secondary OF.
METHODS
From March 2015 to April 2017, 406 patients with OF were assigned to wrist (W; n=132), spine (S; n=78), and hip (H; n=196) according to the site. All subjects were classified as having primary fracture or secondary fracture. Age, fracture site, the risk of future fracture using Fracture Risk Assessment Tool (FRAX) were compared.
RESULTS
The mean age at fracture site was significantly different among the 3 groups, groups W (66.57±10.03), S (73.50±9.07), and H (78.50±7.72). The most common site of OF were in the order of wrist, spine, and hip with the increase of age. The FRAX scores significantly increased (P<0.001) in the order of W (8.35±5.67), S (10.74±6.99), and H (13.88±7.98) in total patient, and same in primary fracture group (W, 7.50±4.18; S, 9.76±5.91; H, 11.93±6.61; P<0.001). The main site of prior fractures in secondary fracture was same lesion, which means that the prior fracture of secondary wrist fracture was wrist fracture such as spine for spine, hip for hip.
CONCLUSIONS
We determined that as age increasing, the major sites of OF were different and FRAX scores increased. The most common site for secondary fracture was the same one. Hence, the risk of subsequent fracture in same site should be noted after patient suffered OF.

Keyword

Emergency service, hospital; Epidemiology; Osteoporotic fractures; Risk assessment

MeSH Terms

Emergencies*
Emergency Service, Hospital*
Epidemiology
Hip
Humans
Osteoporotic Fractures*
Referral and Consultation*
Risk Assessment
Spine
Wrist

Figure

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  Fig. 1 Flowchart of patient inclusion and exclusion data.

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  Fig. 2 Distribution of the fracture sites according to age. Values are presented as the number of patients, with the percentages in parentheses.

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  Fig. 3 Fracture Risk Assessment Tool (FRAX) & hip FRAX scores of patients. (A) Total patients. (B) Patients with first fracture episode. Bold characters indicate significant difference (P<0.05).

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  Fig. 4 Distribution of primary fracture site in different secondary fractures.

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