1. Risk of Recurrent Fracture: A Population-Based Study.
- Author
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Escott, Benjamin G., To, Teresa, Beaton, Dorcas E., and Howard, Andrew W.
- Subjects
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DISEASE relapse , *CONFIDENCE intervals , *DATABASES , *BONE fractures , *MEDICAL information storage & retrieval systems , *LONGITUDINAL method , *MEDICAL history taking , *RURAL conditions , *SEX distribution , *SOFT tissue injuries , *HEAD injuries , *DISEASE incidence , *RETROSPECTIVE studies , *ODDS ratio , *DISEASE risk factors , *CHILDREN - Abstract
OBJECTIVES: To determine if children who sustain a fracture in childhood had an increased rate of fracture later in childhood or early adulthood. The a priori null hypothesis was that children who sustained a fracture would not have an increased rate of future fractures compared with children who did not sustain a fracture when controlling for important covariates. METHODS: This is a population-based retrospective cohort study using health care databases in Ontario. Approximately 2.5 million healthy children aged 0 to 15 years living in Ontario, Canada between April 1, 2003, and March 31, 2004, were included and followed for 7 years. The exposure was occurrence of any fracture during a 1-year baseline period. The main outcome was any fractures during a 7-year follow-up period. RESULTS: A total of 43 154 children suffered a fracture during the baseline year (17.5 fractures per 1000 child years). Children with a baseline fracture had a 60% higher rate of fracture (incidence rate ratio: 1.60; 95% confidence interval: 1.46-1.75; P < .0001) during the followup period after adjustment for sex, rurality, history of previous fracture, and the occurrence of other injuries (head and soft-tissue). CONCLUSIONS: The occurrence of a fracture during childhood was associated with an increased rate of future fractures compared with children who did not suffer a fracture. Attempting to improve childhood bone health by targeting children who present to a fracture clinic with multiple fracture risk factors may be a useful strategy for secondary prevention of fractures and may have beneficial effects on long-term bone health. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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