Osteoporosis, bone & mineral

Excess subsequent fracture and mortality risk after ankle fractures: a relative survival analysis of the 45 and Up Study

Osteoporos IntPublished Prospective cohort study

Authors' conclusion

In the 45 and Up cohort, there was a modest but significant increased risk of fracture following ankle fracture seen in both women and men. In men, but not women, ankle fractures were associated with 10% excess mortality.

Study context

Population
45 and Up Study, NSW, Australia, 2006 to 2017; baseline questionnaire linked to ED, admitted-patient and death registry data1,490,651 person-years
Participants
143,070 vs 123,818
Exposure
Ankle fracture vs overall cohort
  • Womenn = 143,070
  • Menn = 123,818
Outcome
Excess risk of subsequent fracture and mortality following ankle fractures
Follow-up
5 years
Methodological detailspopulation-based, relative survival analysis, linked administrative data
  • Population-based
  • Relative survival analysis
  • Linked administrative data

Main finding

As reported in the abstract

Excess risk of subsequent fracture after ankle fracture, vs risk of incident fracture in the study

Excess risk of subsequent fracture, both women and men

5%

95% CI 3–8%

Observational data: associations, not effects.

Further findings

Cumulative excess mortality after ankle fracture, vs overall cohort · 5 years

Men
10% (95% CI 6-13%)
Women: no excess mortality
  • 78 deaths in women and 76 deaths in men

Characteristics of participants with ankle fractures who died

Older
P < 0.001
More likely to have had a second fracture
P < 0.001
Prior fracture
P < 0.001
More comorbidities
P < 0.001

Original publication

Excess subsequent fracture and mortality risk after ankle fractures: a relative survival analysis of the 45 and Up Study. Osteoporos Int. Published 10 April 2025. doi:10.1007/s00198-025-07400-9

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