Association between a history of major osteoporotic fractures and subsequent hip fracture: a systematic review and meta-analysis.

IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Archives of Osteoporosis Pub Date : 2024-05-31 DOI:10.1007/s11657-024-01393-4
Takashi Ariie, Norio Yamamoto, Yusuke Tsutsumi, Shuri Nakao, Akihiro Saitsu, Takahiro Tsuge, Haruka Tsuda, Yuki Nakashima, Takanori Miura, Yousuke Bandai, Ryota Okoba, Shunsuke Taito
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Abstract

Purpose: A history of fractures involving the distal radius, proximal humerus, spine, and hip may be associated with the incidence of subsequent hip fractures in older people. However, a comprehensive summary of this association using a rigorous methodology is lacking. Our objective was to systematically review the literature and examine the association between four major osteoporotic fractures and subsequent hip fractures in individuals aged ≥ 50 years.

Methods: We searched MEDLINE, Embase, CENTRAL, ICTRP, and ClinicalTrials.gov on February 15, 2023. The search included cohort or case-control studies investigating the association between these four types of osteoporotic fractures and subsequent hip fractures. We pooled the hazard ratios (HRs) with 95% confidence intervals (CI) using the random-effects model. We used the Quality In Prognosis Studies tool to assess the risk of bias in the included studies, and the grading of recommendations assessment, development, and evaluation approach to determine the certainty of evidence.

Results: The selection process identified 48 studies for qualitative synthesis and 23 studies (2,239,217 participants) for meta-analysis. The overall methodological quality had a low risk of bias in 65% of the included studies. The association between a history of major osteoporotic fractures and subsequent hip fracture varied, with a high certainty of evidence for a history of proximal humerus and hip fractures (HR 2.02, 95% CI 1.75-2.33 and 2.86, 95% CI 1.92-4.25, respectively), moderate certainty for distal radius fractures (HR 1.66, 95% CI 1.53-1.81), and low certainty for spine fractures (HR 1.53, 95% CI 1.38-1.69).

Conclusions: In conclusion, a history of major osteoporotic fractures, particularly distal radius, proximal humerus, and hip fractures, is associated with subsequent hip fractures in older adults. Further research is needed to verify the association between a history of spine fracture and subsequent hip fractures.

Protocol registration: Open Science Framework ( https://osf.io/7fjuc ).

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重大骨质疏松性骨折病史与后续髋部骨折之间的关系:系统回顾与荟萃分析。
目的:桡骨远端、肱骨近端、脊柱和髋部的骨折史可能与老年人随后的髋部骨折发生率有关。然而,目前还缺乏采用严格方法对这种关联性进行全面总结的资料。我们的目的是系统回顾文献,研究年龄≥50 岁的人群中四种主要骨质疏松性骨折与后续髋部骨折之间的关系:我们于 2023 年 2 月 15 日检索了 MEDLINE、Embase、CENTRAL、ICTRP 和 ClinicalTrials.gov。搜索结果包括调查这四类骨质疏松性骨折与后续髋部骨折之间关系的队列研究或病例对照研究。我们采用随机效应模型对危险比 (HR) 和 95% 置信区间 (CI) 进行了汇总。我们使用预后研究质量工具评估了纳入研究的偏倚风险,并使用建议分级评估、制定和评价方法确定了证据的确定性:筛选过程中确定了 48 项研究用于定性综合,23 项研究(2239217 名参与者)用于荟萃分析。在纳入的研究中,65%的研究总体方法学质量偏倚风险较低。重大骨质疏松性骨折病史与后续髋部骨折之间的关系各不相同,肱骨近端和髋部骨折病史的证据确定性较高(HR 分别为 2.02,95% CI 1.75-2.33 和 2.86,95% CI 1.92-4.25),桡骨远端骨折的证据确定性中等(HR 1.66,95% CI 1.53-1.81),脊柱骨折的证据确定性较低(HR 1.53,95% CI 1.38-1.69):总之,重大骨质疏松性骨折史,尤其是桡骨远端、肱骨近端和髋部骨折,与老年人随后的髋部骨折有关。需要进一步研究来验证脊柱骨折史与后续髋部骨折之间的关联:协议注册:开放科学框架 ( https://osf.io/7fjuc )。
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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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