Previous Falls Predict Subsequent Fractures in Postmenopausal Women
January 9, 2020

A fall in the previous 12 months predicts fracture in the subsequent 5 years in postmenopausal women, according to a study published in Osteoporosis International.

Conducted at the University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland, the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) included 8,744 women whose mean age at the beginning of the study was approximately 62 years.

The study started in 1999 with an enquiry asking the study participants about their history of falls in the preceding 12 months. A follow-up enquiry was conducted in 2004, asking the study participants about any fractures they had suffered during the 5-year follow-up. The self-reported fractures were confirmed from medical records.

Women were classified by frequency (non/occasional/frequent fallers), mechanism (slip/nonslip), and severity (injurious/ non-injurious) of falls and fractures by site (major osteoporotic/other).

Of the women, 1,693 (19.4%) reported a fall during the preceding 12 months in 1999. These included a slip fall (n = 812), a nonslip fall (n = 654), an injurious fall (n = 379), and a non-injurious fall (n = 1,308).

During the 5-year follow-up, 811 women (9.3%) sustained a subsequent fracture -- 431 major osteoporotic fractures and 380 other fractures.

The risk of fracture was 41% greater in women who had reported a fall in comparison to those who hadn’t and slip falls were associated with a greater risk of subsequent fracture than falls caused by other reasons.

Compared with non-fallers, earlier falls predicted subsequent fractures with an odds ratio (OR) of 1.41 (95% confidence interval [CI], 1.19-1.67; P P = .002) and earlier nonslip falls (OR = 1.35; 95% CI, 1.04-1.74; P = .02).

The risk of future fractures was 64% higher among women who had experienced an injurious fall (OR = 1.64; 95% CI, 1.21-2.23; P P 

“Our results indicate that a history of falls, especially injurious falls, appeared to be an indicator for subsequent fracture overall,” wrote Heikki Kröger, University of Eastern Finland, and colleagues. “Earlier injurious falls were stronger predictors for future other fractures than for typical major osteoporotic fractures.”

Reference: https://link.springer.com/article/10.1007%2Fs00198-019-05255-5

SOURCE: University of Eastern Finland