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

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Bisphosphonate Use After Hip Fracture in Older Adults : A Nationwide Retrospective Cohort Study. / Nordström, Peter; Toots, Annika; Gustafson, Yngve; Thorngren, Karl Göran; Hommel, Ami; Nordström, Anna.

I: Journal of the American Medical Directors Association, Vol. 18, Nr. 6, 2017, s. 515-521.

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Nordström, Peter ; Toots, Annika ; Gustafson, Yngve ; Thorngren, Karl Göran ; Hommel, Ami ; Nordström, Anna. / Bisphosphonate Use After Hip Fracture in Older Adults : A Nationwide Retrospective Cohort Study. I: Journal of the American Medical Directors Association. 2017 ; Vol. 18, Nr. 6. s. 515-521.

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TY - JOUR

T1 - Bisphosphonate Use After Hip Fracture in Older Adults

T2 - Journal of the American Medical Directors Association

AU - Nordström, Peter

AU - Toots, Annika

AU - Gustafson, Yngve

AU - Thorngren, Karl Göran

AU - Hommel, Ami

AU - Nordström, Anna

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Bisphosphonates

KW - Cohort study

KW - Hip fractures

KW - Older individuals

UR - http://www.scopus.com/inward/record.url?scp=85013414268&partnerID=8YFLogxK

U2 - 10.1016/j.jamda.2016.12.083

DO - 10.1016/j.jamda.2016.12.083

M3 - Article

VL - 18

SP - 515

EP - 521

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

SN - 1525-8610

IS - 6

ER -