The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study.
BACKGROUND
The clinical significance of the high prevalence of osteopenia in inflammatory bowel disease is unclear.


OBJECTIVE
To determine whether persons with inflammatory bowel disease have increased incidence of fracture.


METHODS
Population-based matched cohort study.


METHODS
Manitoba, Canada.


METHODS
Patients with inflammatory bowel disease in the University of Manitoba IBD Database (n = 6027) were matched to 10 randomly selected persons in the general population without inflammatory bowel disease (n = 60 270) by year, age, sex, and postal area of residence.


METHODS
The incidence of hospitalization for hip fracture was determined on the basis of hospital discharge abstracts. Outpatient medical billing records and hospital discharge abstracts were used to calculate the incidence of spine, rib, and forearm fractures. Rates were calculated on the basis of person-years of follow-up for 1984 to 1997.


RESULTS
Persons with inflammatory bowel disease had significantly increased incidence of fractures at the spine (incidence rate ratio [IRR], 1.74 [95% CI, 1.34 to 2.24]; P < 0.001), hip (IRR, 1.59 [CI, 1.27 to 2.00]; P < 0.001), wrist/forearm (IRR, 1.33 [CI, 1.11 to 1.58]; P = 0.001), and rib (IRR, 1.25 [CI, 1.02 to 1.52]; P = 0.03) and of any of these fractures (IRR, 1.41 [CI, 1.27 to 1.56]; P < 0.001).


CONCLUSIONS
The incidence of fracture among persons with inflammatory bowel disease is 40% greater than that in the general population.
Bernstein
C N
CN
Section of Gastroenterology, University of Manitoba, 804F-715 McDermot Avenue, John Buhler Research Centre, Winnipeg, Manitoba R3E 3P4, Canada. cbernst@cc.umanitoba.ca
Blanchard
J F
JF
Leslie
W
W
Wajda
A
A
Yu
B N
BN
D000328:Adult; D001851:Bone Diseases, Metabolic / Q000150:complications; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005543:Forearm Injuries / Q000453:epidemiology / Q000209:etiology; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology*; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012253:Rib Fractures / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology