Multimorbidity double burden: elevated refracture risk despite high mortality following fractures—a linked cohort study
Authors' conclusion
Multimorbidity does not attenuate refracture risk; instead, it heightens vulnerability among older fracture patients, even in the presence of competing mortality.
Study context
- Population
- Adults aged ≥50 years in New South Wales, Australia, with a fracture between 1 January 2005 and 30 June 2021; 31.2% men (mean [SD] age 76.3 (10.7) years), 68.8% women (77.4 [10.7] years)individuals with fractures
- Participants
- 335,308 adults
- Exposure
- Multimorbidity clusters vs general NSW population
- Outcome
- Refracture risk across multimorbidity clusters and fracture sites
- Follow-up
- Followed until 30 June 2022
Methodological detailswhole-of-population data linkage, latent class analysis, Fine-Gray subdistribution and Cox proportional hazards models
- Whole-of-population data linkage
- Latent class analysis
- Fine-Gray subdistribution and Cox proportional hazards models
Main finding
As reported in the abstract
Refracture risk vs general NSW population
All clusters: HR range in men
2.39-3.38
All clusters: HR range in women
1.62-2.36
Observational data: associations, not effects.
Further findings
Competing mortality vs general NSW population
- All clusters: HR range in men
- 1.58-4.52
- All clusters: HR range in women
- 1.13-3.08
Refracture risk by fracture site
- Distal fracture sites were associated with higher refracture risk due to lower mortality
Original publication
Multimorbidity double burden: elevated refracture risk despite high mortality following fractures—a linked cohort study. J Bone Miner Res. Published 22 August 2026. doi:10.
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