Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)
dc.contributor.author | Dennison, Elaine M. | |
dc.contributor.author | Compston, Juliet E. | |
dc.contributor.author | Flahive, Julie | |
dc.contributor.author | Siris, Ethel S. | |
dc.contributor.author | Gehlbach, Stephen H. | |
dc.contributor.author | Boonen, Steven | |
dc.contributor.author | Chapurlat, Roland D. | |
dc.contributor.author | Diez-Perez, Adolfo | |
dc.contributor.author | Anderson, Frederick A. Jr. | |
dc.contributor.author | Hooven, Frederick H. | |
dc.contributor.author | LaCroix, Andrea Z. | |
dc.contributor.author | Lindsay, Robert | |
dc.contributor.author | Netelenbos, J. Coen | |
dc.contributor.author | Pfeilschifter, Johannes | |
dc.contributor.author | Rossini, Maurizio | |
dc.contributor.author | Roux, Christian | |
dc.contributor.author | Saag, Kenneth G. | |
dc.contributor.author | Sambrook, Phillip N. | |
dc.contributor.author | Silverman, Stuart | |
dc.contributor.author | Watts, Nelson B. | |
dc.contributor.author | Greenspan, Susan L. | |
dc.contributor.author | Premaor, Melissa | |
dc.contributor.author | Cooper, Cyrus | |
dc.date | 2022-08-11T08:08:08.000 | |
dc.date.accessioned | 2022-08-23T15:43:45Z | |
dc.date.available | 2022-08-23T15:43:45Z | |
dc.date.issued | 2012-06-01 | |
dc.date.submitted | 2012-08-24 | |
dc.identifier.citation | Bone. 2012 Jun;50(6):1288-93. Epub 2012 Mar 9. <a href="http://dx.doi.org/10.1016/j.bone.2012.02.639">Link to article on publisher's site</a> | |
dc.identifier.issn | 1873-2763 (Linking) | |
dc.identifier.doi | 10.1016/j.bone.2012.02.639 | |
dc.identifier.pmid | 22426498 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/27165 | |
dc.description.abstract | INTRODUCTION: Greater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX. MATERIALS AND METHODS: We used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates. RESULTS: Of 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson's disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6-3.1; P<0.001). Co-morbidities that contributed most to fracture prediction in a Cox regression model with FRAX risk factors as additional predictors were: Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, osteoarthritis, and heart disease. CONCLUSION: Co-morbidities, as captured in a co-morbidity index, contributed significantly to fracture risk in this study population. Parkinson's disease carried a particularly high risk of fracture; and increasing co-morbidity index was associated with increasing fracture risk. Addition of co-morbidity index to FRAX risk factors improved fracture prediction. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22426498&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://dx.doi.org/10.1016/j.bone.2012.02.639 | |
dc.subject | Osteoporosis | |
dc.subject | Osteoporosis, Postmenopausal | |
dc.subject | Osteoporotic Fractures | |
dc.subject | Fractures, Bone | |
dc.subject | Health Services Research | |
dc.subject | Musculoskeletal Diseases | |
dc.title | Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW) | |
dc.type | Journal Article | |
dc.source.journaltitle | Bone | |
dc.source.volume | 50 | |
dc.source.issue | 6 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/cor_glow/6 | |
dc.identifier.contextkey | 3257190 | |
html.description.abstract | <p>INTRODUCTION: Greater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX.</p> <p>MATERIALS AND METHODS: We used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates.</p> <p>RESULTS: Of 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson's disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6-3.1; P<0.001). Co-morbidities that contributed most to fracture prediction in a Cox regression model with FRAX risk factors as additional predictors were: Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease, osteoarthritis, and heart disease.</p> <p>CONCLUSION: Co-morbidities, as captured in a co-morbidity index, contributed significantly to fracture risk in this study population. Parkinson's disease carried a particularly high risk of fracture; and increasing co-morbidity index was associated with increasing fracture risk. Addition of co-morbidity index to FRAX risk factors improved fracture prediction.</p> | |
dc.identifier.submissionpath | cor_glow/6 | |
dc.contributor.department | Center for Outcomes Research | |
dc.source.pages | 1288-93 |
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