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Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint.

Publication ,  Journal Article
Colón-Emeric, C; Pieper, CF; Grubber, J; Van Scoyoc, L; Schnell, ML; Van Houtven, CH; Pearson, M; Lafleur, J; Lyles, KW; Adler, RA
Published in: Bone
December 2015

PURPOSE: With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. METHODS: Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between 1999 and 2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics were used to describe the correlation between each fracture type and hip fracture within individuals, without regard to the timing of the events. RESULTS: 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, the rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). CONCLUSIONS: Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider the use of a composite endpoint to better estimate hip fracture risk.

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Published In

Bone

DOI

EISSN

1873-2763

Publication Date

December 2015

Volume

81

Start / End Page

67 / 71

Location

United States

Related Subject Headings

  • Pelvis
  • Patient Selection
  • Osteoporotic Fractures
  • Osteoporosis
  • Middle Aged
  • Male
  • Incidence
  • Humerus
  • Humans
  • Hip Fractures
 

Citation

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Chicago
ICMJE
MLA
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Colón-Emeric, C., Pieper, C. F., Grubber, J., Van Scoyoc, L., Schnell, M. L., Van Houtven, C. H., … Adler, R. A. (2015). Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint. Bone, 81, 67–71. https://doi.org/10.1016/j.bone.2015.07.003
Colón-Emeric, Cathleen, Carl F. Pieper, Janet Grubber, Lynn Van Scoyoc, Merritt L. Schnell, Courtney Harold Van Houtven, Megan Pearson, Joanne Lafleur, Kenneth W. Lyles, and Robert A. Adler. “Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint.Bone 81 (December 2015): 67–71. https://doi.org/10.1016/j.bone.2015.07.003.
Colón-Emeric C, Pieper CF, Grubber J, Van Scoyoc L, Schnell ML, Van Houtven CH, et al. Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint. Bone. 2015 Dec;81:67–71.
Colón-Emeric, Cathleen, et al. “Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint.Bone, vol. 81, Dec. 2015, pp. 67–71. Pubmed, doi:10.1016/j.bone.2015.07.003.
Colón-Emeric C, Pieper CF, Grubber J, Van Scoyoc L, Schnell ML, Van Houtven CH, Pearson M, Lafleur J, Lyles KW, Adler RA. Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint. Bone. 2015 Dec;81:67–71.

Published In

Bone

DOI

EISSN

1873-2763

Publication Date

December 2015

Volume

81

Start / End Page

67 / 71

Location

United States

Related Subject Headings

  • Pelvis
  • Patient Selection
  • Osteoporotic Fractures
  • Osteoporosis
  • Middle Aged
  • Male
  • Incidence
  • Humerus
  • Humans
  • Hip Fractures