SAT0607 INCIDENCE AND SEVERITY OF FRAGILITY FRACTURES IN FRANCE. (June 2019) - Cortet, Bernard
Abstract : Background: Certain fragility fractures (for example of the hip and femur) in the elderly are considered major since they are associated with increased mortality and morbidity. 1 Objectives: To describe the characteristics of adults aged ≥50 years in France experiencing fragility fractures according to the site of fracture. Methods: A postal questionnaire was sent to 15, 000 individuals aged ≥50 years in order to identify and characterise subjects with a history of fragility fracture. Subjects were asked whether they had experienced a fracture in the previous 3 years and, if so, how many. Fractures were classified according to site into major (shoulder, vertebrae, pelvis, hip or femur and ≥3 ribs) or minor (other sites). 1 Results: Of the 13, 914 subjects returning the questionnaire, 425 (3%) reported ≥1 fragility fracture. The fracture history rate in the previous year was 1.4% [95%CI: 1.2–1.6]; this rate was higher in women (2.0%) than in men (0.7%) and increased with age. 147 subjects reported major fractures and 287 subjects minor fractures. Most fractures (82.4%) resulted from falling over. The most frequent major fracture sites were the humerus (10.6% of all fractures), vertebra (8.1%) and hip (7.1%). The most frequent minor fracture sites were the forearm/wrist (24.7%) and ankle (17.7%). 25 subjects reported >1 fractures and were excluded from further analyses. Subjects with a history of major fractures were older (p<0.01) than those with minor fractures (72.6±11.3 vs. 67.1±10.6 years; p<0.01). Distribution of gender, body mass index and comorbidities did not differ between prior fracture types. Current obesity was, however, associated with a higher rate of previous fracture of the lower limb. Subjects with a history of major fractures reported a significantly greater loss in height since the age of 20 (p<0.01) than those with a history of minor fractures (-3.38±2.35 vs. -2.75±2.02 cm). Subjects who reported lifetime corticosteroid use for ≥3 months more frequently reported major fractures than minor fractures (odds ratio: 1.90 [1.13;3.18]), as did post-menopausal women (odds ratio: 4.64[1.06;20.43]) and women using oestrogen-based hormone replacement therapy (odds ratio: 1.86 [1.06;3.29]). Parental fracture history, a history of falls, excess alcohol consumption or active smoking, and use of drugs that may increase risk of falls (antidepressants, antiepileptic drugs) were not associated with the type of fracture. Conclusion: Extrapolated to the total French population, >340, 000 people aged ≥50 years would be expected to experience a fragility fracture each year. One third of these fractures are major. Characteristics found to be associated with the severity of the prior fracture were older age, corticosteroid use, post-menopausal status and use of oestrogens. Limitations of the study include retrospective data collection, risk of recall bias, lack of ascertainment of fracture history and failure to capture subjects in residential care or who had died since the fracture. References: [1] Bliuc, et al. JAMA 2009; 301:513-21. Acknowledgement: The study was jointly conducted and funded by AFLAR and UCB. Editorial support was provided by Foxymed, funded by UCB Disclosure of Interests: Bernard Cortet Consultant for: Bernard Cortet has received consultancy honoraria of speaker's fees from Amgen, Expanscience, Ferring, Lilly, Medtronic, MSD, Novartis, Roche diagnostics, Théramex and UCB, Pierre Chauvin: None declared, Jean-Marc Feron Consultant for: Jean-Marc Feron has received consultancy honoraria and conference fees from UCB, Amgen and Lilly, LAURENT GRANGE Consultant for: Laurent Grange has received honoraria from Amgen, Lilly and UCB and research support from Lilly, Amgen, UCB, Expanscience, Mylan, Roche diagnostics and TEVA, Alain Coulomb: None declared, Robert Launois: None declared, Francoise Alliot Launois: None declared, Rahma Sellami: None declared, Chantal Touboul: None declared, Benoit Vincent Employee of: Benoit Vincent is an employee of UCB Pharma, France, Jean-Michel Joubert Employee of: Jean-Michel Joubert is an employee of UCB Pharma, France, Karine Briot Consultant for: Karine Briot has received consultancy honoraria and conference fees from UCB, Amgen, Lilly and MSD