Objectives: To evaluate the risk of subsequent fractures in patients who attended the Fracture Liaison Service (FLS), with and without incident falls after the index fracture.
Design: A 3-year prospective observational cohort study.
Setting: An outpatient FLS in the Netherlands.
Participants: Patients aged 50+ years with a recent clinical fracture.
Outcome measures: Incident falls and subsequent fractures.
Results: The study included 488 patients (71.9% women, mean age: 64.6±8.6 years). During the 3-year follow-up, 959 falls had been ascertained in 296 patients (60.7%) (ie, fallers), and 60 subsequent fractures were ascertained in 53 patients (10.9%). Of the fractures, 47 (78.3%) were fall related, of which 25 (53.2%) were sustained at the first fall incident at a median of 34 weeks. An incident fall was associated with an approximately 9-fold (HR: 8.6, 95% CI 3.1 to 23.8) increase in the risk of subsequent fractures.
Conclusion: These data suggest that subsequent fractures among patients on treatment prescribed in an FLS setting are common, and that an incident fall is a strong predictor of subsequent fracture risk. Immediate attention for fall risk could be beneficial in an FLS model of care.
Trial registration number: NL45707.072.13.
Keywords: general medicine (see Internal Medicine); internal medicine; orthopaedic & trauma surgery.
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