Osteoporosis intervention following distal forearm fractures: A missed opportunity?

Maria Teresa Cuddihy, Sherine E. Gabriel, Cynthia Crowson, Elizabeth J. Atkinson, Claudia Tabini, W. Michael O'Fallon, L. Joseph Melton

Research output: Contribution to journalArticle

161 Citations (Scopus)

Abstract

Background: Fractures are a manifestation of osteoporosis, but therapeutic interventions to reduce the risk of recurrent fractures are not widespread. Objective: To identify predictors of osteoporosis treatment in postmenopausal women following distal forearm fracture. Methods: This population-based retrospective cohort study included all postmenopausal women, 45 years or older, residing in Olmsted County, Minnesota, who sustained a distal forearm fracture due to minimal trauma (a fall from standing height or under) in 1993 to 1997. Complete medical records were reviewed for each subject and Cox proportional hazards regression was used to evaluate the relationship of baseline demographic and clinical characteristics to therapeutic interventions for osteoporosis within 12 months following the fracture. Results: A total of 343 women with a mean age of 70.5 years had a minimal trauma distal forearm fracture. Within 12 months, 83% had seen a nonorthopedic physician. Of these, 17% had a pharmacologic osteoporosis intervention and the 12-month actuarially estimated cumulative incidence of any intervention was 18% (95% confidence interval [CI], 14%-22%). In a multivariate analysis, treatment was more likely to be offered to those with a prior diagnosis of osteoporosis (relative risk [RR], 2.08; 95% CI, 1.21-3.58), previous distal forearm fracture (RR, 2.38; 95% CI, 1.30-4.34), or history of cigarette smoking (RR, 1.86; 95% CI, 1.11-3.12). Conclusions: Effective osteoporosis interventions are underutilized among postmenopausal women who experience an osteoporotic fracture. Further work is needed to overcome barriers to optimal osteoporosis management in these women who are at high risk for future complications of osteoporosis.

Original languageEnglish (US)
Pages (from-to)421-426
Number of pages6
JournalArchives of Internal Medicine
Volume162
Issue number4
StatePublished - Feb 25 2002

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Forearm
Osteoporosis
Confidence Intervals
Osteoporotic Fractures
Wounds and Injuries
Therapeutics
Medical Records
Cohort Studies
Multivariate Analysis
Retrospective Studies
Smoking
Demography
Physicians
Incidence
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Cuddihy, M. T., Gabriel, S. E., Crowson, C., Atkinson, E. J., Tabini, C., O'Fallon, W. M., & Melton, L. J. (2002). Osteoporosis intervention following distal forearm fractures: A missed opportunity? Archives of Internal Medicine, 162(4), 421-426.

Osteoporosis intervention following distal forearm fractures : A missed opportunity? / Cuddihy, Maria Teresa; Gabriel, Sherine E.; Crowson, Cynthia; Atkinson, Elizabeth J.; Tabini, Claudia; O'Fallon, W. Michael; Melton, L. Joseph.

In: Archives of Internal Medicine, Vol. 162, No. 4, 25.02.2002, p. 421-426.

Research output: Contribution to journalArticle

Cuddihy, MT, Gabriel, SE, Crowson, C, Atkinson, EJ, Tabini, C, O'Fallon, WM & Melton, LJ 2002, 'Osteoporosis intervention following distal forearm fractures: A missed opportunity?', Archives of Internal Medicine, vol. 162, no. 4, pp. 421-426.
Cuddihy MT, Gabriel SE, Crowson C, Atkinson EJ, Tabini C, O'Fallon WM et al. Osteoporosis intervention following distal forearm fractures: A missed opportunity? Archives of Internal Medicine. 2002 Feb 25;162(4):421-426.
Cuddihy, Maria Teresa ; Gabriel, Sherine E. ; Crowson, Cynthia ; Atkinson, Elizabeth J. ; Tabini, Claudia ; O'Fallon, W. Michael ; Melton, L. Joseph. / Osteoporosis intervention following distal forearm fractures : A missed opportunity?. In: Archives of Internal Medicine. 2002 ; Vol. 162, No. 4. pp. 421-426.
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abstract = "Background: Fractures are a manifestation of osteoporosis, but therapeutic interventions to reduce the risk of recurrent fractures are not widespread. Objective: To identify predictors of osteoporosis treatment in postmenopausal women following distal forearm fracture. Methods: This population-based retrospective cohort study included all postmenopausal women, 45 years or older, residing in Olmsted County, Minnesota, who sustained a distal forearm fracture due to minimal trauma (a fall from standing height or under) in 1993 to 1997. Complete medical records were reviewed for each subject and Cox proportional hazards regression was used to evaluate the relationship of baseline demographic and clinical characteristics to therapeutic interventions for osteoporosis within 12 months following the fracture. Results: A total of 343 women with a mean age of 70.5 years had a minimal trauma distal forearm fracture. Within 12 months, 83{\%} had seen a nonorthopedic physician. Of these, 17{\%} had a pharmacologic osteoporosis intervention and the 12-month actuarially estimated cumulative incidence of any intervention was 18{\%} (95{\%} confidence interval [CI], 14{\%}-22{\%}). In a multivariate analysis, treatment was more likely to be offered to those with a prior diagnosis of osteoporosis (relative risk [RR], 2.08; 95{\%} CI, 1.21-3.58), previous distal forearm fracture (RR, 2.38; 95{\%} CI, 1.30-4.34), or history of cigarette smoking (RR, 1.86; 95{\%} CI, 1.11-3.12). Conclusions: Effective osteoporosis interventions are underutilized among postmenopausal women who experience an osteoporotic fracture. Further work is needed to overcome barriers to optimal osteoporosis management in these women who are at high risk for future complications of osteoporosis.",
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AB - Background: Fractures are a manifestation of osteoporosis, but therapeutic interventions to reduce the risk of recurrent fractures are not widespread. Objective: To identify predictors of osteoporosis treatment in postmenopausal women following distal forearm fracture. Methods: This population-based retrospective cohort study included all postmenopausal women, 45 years or older, residing in Olmsted County, Minnesota, who sustained a distal forearm fracture due to minimal trauma (a fall from standing height or under) in 1993 to 1997. Complete medical records were reviewed for each subject and Cox proportional hazards regression was used to evaluate the relationship of baseline demographic and clinical characteristics to therapeutic interventions for osteoporosis within 12 months following the fracture. Results: A total of 343 women with a mean age of 70.5 years had a minimal trauma distal forearm fracture. Within 12 months, 83% had seen a nonorthopedic physician. Of these, 17% had a pharmacologic osteoporosis intervention and the 12-month actuarially estimated cumulative incidence of any intervention was 18% (95% confidence interval [CI], 14%-22%). In a multivariate analysis, treatment was more likely to be offered to those with a prior diagnosis of osteoporosis (relative risk [RR], 2.08; 95% CI, 1.21-3.58), previous distal forearm fracture (RR, 2.38; 95% CI, 1.30-4.34), or history of cigarette smoking (RR, 1.86; 95% CI, 1.11-3.12). Conclusions: Effective osteoporosis interventions are underutilized among postmenopausal women who experience an osteoporotic fracture. Further work is needed to overcome barriers to optimal osteoporosis management in these women who are at high risk for future complications of osteoporosis.

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