Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study

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title = "Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study",
abstract = "Objectives: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age. Design, setting, and participants: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals. Main outcome measure: A new hip fracture. Results: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95{\%} confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95{\%} CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95{\%} CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95{\%} CI, 0.86-1.05). Conclusion: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.",
keywords = "Bisphosphonates, Cohort study, Hip fractures, Older individuals",
author = "Peter Nordstr{\"o}m and Annika Toots and Yngve Gustafson and Thorngren, {Karl G{\"o}ran} and Ami Hommel and Anna Nordstr{\"o}m",
year = "2017",
doi = "10.1016/j.jamda.2016.12.083",
language = "English",
volume = "18",
pages = "515--521",
journal = "Journal of the American Medical Directors Association",
issn = "1525-8610",
publisher = "Elsevier",
number = "6",