Fractures at virtually all sites are associated with adverse outcomes: an observational study
Authors' conclusion
MOF and NonMOF showed comparable risks of subsequent fracture and mortality. All sites are associated with adverse outcomes and should be addressed in clinical care guidelines.
Study context
- Population
- Women and men aged 60+ from the Canadian Multicentre Osteoporosis Study and Dubbo Osteoporosis Epidemiology Study7,568 women · 3366 men
- Exposure
- Initial NonMOF vs major osteoporotic fractures (MOF): subsequent fracture and mortality risks
- Outcome
- Subsequent fracture and mortality following initial fracture
Methodological detailstwo longitudinal cohorts (CaMos and DOES), 1998 initial fractures (38% NonMOF) in women, 484 (48% NonMOF) in men
- Two longitudinal cohorts (CaMos and DOES)
- 1998 initial fractures (38% NonMOF) in women, 484 (48% NonMOF) in men
Main finding
As reported in the abstract
Subsequent fracture risk, compared to initial fracture
Hazard ratio (95% CI)
NonMOFwomen
1.69(1.47–1.95)
NonMOFmen
2.06(1.52–2.80)
MOFwomen
1.76(1.56–1.98)
MOFmen
2.09(1.53–2.85)
Observational data: associations, not effects.
Further findings
Mortality, compared to fracture-free population
| HR (CI) | ||
|---|---|---|
| NonMOFWomen | 1.37 (1.16–1.60) | |
| NonMOFMen | 1.33 (1.03–1.72) | |
| MOFWomen | 1.75 (1.54–1.99) | |
| MOFMen | 2.26 (1.81–2.81) | |
| 0.20.5125Hazard ratio (log scale) |
- NonMOF excess mortality lower than MOF but still substantial
Anatomical classification (hip, vertebral, proximal, distal)
- All anatomical sites associated with subsequent fracture risk; mortality risk increased incrementally from distal to proximal, vertebral and hip
Original publication
Fractures at virtually all sites are associated with adverse outcomes: an observational study. J Bone Miner Res. Published 13 March 2026. doi:10.
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