Risk and adverse outcomes of fractures in patients with liver cirrhosis: two nationwide retrospective cohort studies. Issue 10 (8th October 2017)

• Record Type: Journal Article
• Authors: Chen, Ta-Liang; Lin, Chao-Shun; Shih, Chun-Chuan; Huang, Yu-Feng; Yeh, Chun-Chieh; Wu, Chih-Hsing; Cherng, Yih-Giun; Liao, Chien-Chang
• Is Part Of: BMJ open. Volume 7:Issue 10(2017)
• Publication Date: 2017-10-08
• Subjects: liver cirrhosis -- fracture -- risk -- outcome; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2017-017342
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: The aim of this study is to evaluate fracture risk and post-fracture outcomes in patients with and without liver cirrhosis (LC). Design: Retrospective cohort study and nested fracture cohort study. Setting: This study was based on Taiwan's National Health Insurance Research Database that included information on: (1) 3941 patients aged 20 years and older newly diagnosed with LC between 2000 and 2003; (2) 688290 hospitalised fracture patients aged 20 years and older between 2006 and 2013. Primary and secondary outcome measures: Followed-up events of fracture from 2000 to 2008 were noted from medical claims to evaluate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of fracture associated with LC. Adjusted odds ratios (ORs) and 95% CIs of adverse events after fracture were compared among patients with and without LC Results: The incidences of fracture for people with and without LC were 29.1 and 17.2 per 1000 person-years, respectively. Compared with controls, the adjusted HR of fracture was 1.83 (95% CI 1.67 to 2.01) for patients with LC. Previous LC was associated with risks of septicaemia (OR 1.77, 95% CI 1.60 to 1.96), acute renal failure (OR 1.63, 95% CI 1.33 to 1.99), and 30-day in-hospital mortality (OR 1.61, 95 %CI 1.37 to 1.89) after fracture. Conclusion: LC was associated with higher risk of fracture; patients with LC in particular had more complications and 30-day in-hospital mortality after fracture. Fracture prevention and attention to post-fracture adverse events are needed for these susceptible populations.