Patients with type II diabetes have an increased risk of subsequent fractures beyond imminent risk period: a survival analysis
DOI:
https://doi.org/10.35366/112695Keywords:
diabetes mellitus, subsequent fracture, fragility fracture, survival analysisAbstract
Introduction: development of subsequent fragility fractures has been linked to previous fractures, age,
biological sex and type 2 diabetes mellitus (T2DM). Diabetes may induce osteometabolic disorders
that lead to increased fracture risk, relation with subsequent fractures remains unclear. Objective: to
establish the impact of previous fractures, age, sex, and type 2 diabetes diagnosis on risk of subsequent
fractures in patients who had sustained an index hip fracture in time through a survival analysis.
Material and methods: retrospective, observational and descriptive study. From a database of 670
records of patients aged ≥ 50 years who had sustained an index hip fracture between 2014-2017,
with follow-up at least two months. Retrieved information: previous fracture, age, sex, diabetes and
subsequent fracture. Statistical analysis: central tendency, dispersion, frequency and percentages,
t-Student, χ2 test, Kaplan-Meyer method, log-rank test, Cox regression model. Results: we included
570 patients, mean age 80.09 ± 9.45 years, 79.8% women. Mean follow-up time 24.8 ± 20.8 months.
Subsequent fractures on 96 cases, the mean time to subsequent fracture was 25.9 ± 19.5 months; of
these 56.2% occurred within two years after incident fracture. No associations were found between
previous fracture (p = 0.3), sex (p = 0.265), and diabetes (p = 0.54) for subsequent fractures. Survival
analysis only found association for subsequent fractures with diabetes (p = 0.01) and biological sex
(p = 0.03). Cox regression analysis model showed an increased risk only for diabetes (HR = 3.8;
p = 0.017; 95% CI 1.275-11.484). Conclusion: patients with type 2 diabetes had an increased risk
of developing subsequent fractures in time. Men patients develop subsequent fractures earlier.
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