A fall in the previous 12 months predicts fracture in the subsequent 5 years in postmenopausal women
journal contributionposted on 2020-01-01, 00:00 authored by N Afrin, R Sund, R Honkanen, H Koivumaa-Honkanen, T Rikkonen, Lana WilliamsLana Williams, H Kröger
© 2019, The Author(s). Purpose: The purpose of this study was to evaluate if a history of falls predicts future postmenopausal fractures and if this prediction variesaccording to frequency, mechanism, and severity of falls and site of fractures. Methods: This study used data from OSTPRE prospective cohort. Total study population consisted of 8744 postmenopausal women (mean age 62.2 years) who responded to postal enquiry in 1999 (baseline) and in 2004 (follow-up). Results: 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). A total of 1693 (19.4%) women reported a fall during the preceding 12 months in 1999; 812 a slip fall, 654 a nonslip, 379 an injurious fall, and 1308 a non-injurious fall. A total of 811 women (9.3%) sustained a fracture during the 5-year follow-up period (1999–2004); 431 major osteoporotic fractures and 380 other fractures. Compared with non-fallers, earlier falls predicted subsequent fractures with an OR of 1.41 (95% CI 1.19–1.67, p ≤ 0.001), 1.43 (95% CI 1.14–1.80, p = 0.002) for earlier slip falls, and 1.35 (95% CI 1.04–1.74, p = 0.02) for earlier nonslip falls. Earlier injurious falls predicted future fractures (OR = 1.64, 95% CI 1.21–2.23, p ≤ 0.01), especially other fractures (OR = 1.86, 95% CI 1.24–2.80, p ≤ 0.01), but not major osteoporotic fractures (OR = 1.37, 95% CI 0.89–2.10, p = 0.151). Fracture risk predictions for earlier non-injurious falls was OR = 1.36, 95% CI 1.12–1.64, p = 0.002. These risk patterns remain same after adjustments. Conclusion: History of falls (especially injurious falls) predicts subsequent fractures (mainly other fractures compared with major osteoporotic fractures) inpostmenopausal women. Summary: We aimed to investigate if history of falls (frequency, mechanism, and severity) is a predictor of future fractures in postmenopausal women. Our results indicate that history of falls (especially injurious falls) appeared to be an indicator for subsequent fracture overall. Earlier injurious falls were stronger predictors for future other fractures than for typical major osteoporotic fractures.