Incidence of fractures in patients with multiple sclerosis: the Danish National Health Registers

Mult Scler. 2012 May;18(5):622-7. doi: 10.1177/1352458511426739. Epub 2011 Oct 21.

Abstract

Background: Patients with multiple sclerosis (MS) are potentially at high risk of fracture due to falls and osteoporosis.

Objective: To estimate incidence rates of fractures in MS patients, stratified by fracture type, sex and age, and to compare these rates with controls.

Methods: The case population consisted of all patients with an accepted diagnosis of MS in the Danish MS Registry (1949-2007). Data were linked to the National Hospital Discharge Register (1977-2007). Patients with MS (n = 11,157) were 1:6 matched by year of birth, gender, calendar time and region to persons without MS (controls). Incidence rates of fracture were estimated as the number of fractures per 1000 person-years. Incidence rate ratios (IRRs) were calculated by dividing fracture rates in MS patients by fracture rates in controls.

Results: Among patients with MS, the incidence rate of any fracture yielded 22.8 per 1000 person-years. The IRR of any fracture between MS patients and controls was 1.40 (95% CI 1.33-1.46). In particular, IRRs of tibia fracture (3.36 [2.75-4.11]), femur fracture (6.66 [5.06-8.76]) and hip fracture (3.20 [2.83-3.62]) were elevated in MS patients versus controls.

Conclusion: Fractures occurred more often in patients with MS, especially fractures of the tibia, hip and femur.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Denmark / epidemiology
  • Female
  • Femoral Fractures / epidemiology
  • Fractures, Bone / epidemiology*
  • Hip Fractures / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multiple Sclerosis / epidemiology*
  • Odds Ratio
  • Osteoporosis / epidemiology
  • Registries
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • Tibial Fractures / epidemiology
  • Time Factors
  • Young Adult