- Design
- Retrospective claims-based cohort study
- Population
- 467,721 US women aged ≥50 with an incident clinical fracture
- Primary outcome
- Subsequent fracture ≥90 days after the index fracture
- Effect
- 24-month risk 19.4%; treatment started in 17.5%
A US claims cohort in The American Journal of Medicine (5 October) followed 467,721 women aged 50 or over after an incident clinical fracture between 2012 and 2021. Median age was 76.
Within two years, 19.4% had a further fracture — 27.8% after a vertebral fracture and 24.2% after a pelvic one. Risk rose with age and with a prior osteoporosis diagnosis. Yet only 17.5% started osteoporosis medication within two years, and most who did started within six months.
The fracture admission is the moment this gap is created and the easiest place to close it. Physicians managing these patients on medical or orthogeriatric wards are well placed to start or plan treatment before discharge.
- One in five women had another fracture within two years of the first
- Vertebral and pelvic fractures carried the highest risk of a further fracture
- Only about one in six started osteoporosis treatment
- Start or document a treatment plan before discharge; most treatment that happens begins early
Why it matters
The highest-risk window for a second fracture is the period when most women remain untreated.
Don't overread it
Claims data show what was prescribed, not why treatment was withheld, and come from a US insured population.
The statistics, in plain English
The 19.4% figure is a cumulative incidence: the share who had a further fracture by two years, adjusted for those who died or left the database. It describes risk without treatment for most of the cohort, which is why it is so high.
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