title: Prior fracture as a risk factor for future fracture in an Australian cohort.
abstract: CONCLUSIONS
  This study investigated the influence of prior fracture on the risk of subsequent fracture. There was a higher risk of subsequent fracture in both young and older adult age groups when Australian males or females had already sustained a prior fracture. Fracture prevention is important throughout life for both sexes.
  
  
  BACKGROUND
  The purpose of this study was to determine the impact of prior fracture on the risk of subsequent fracture across the adult age range in Australian males and females.
  
  
  METHODS
  All-cause fractures were grouped into age categories for males and females enrolled in the Geelong Osteoporosis Study (Australia) using retrospective self-report data and prospective radiology-confirmed data. For all age categories, the relative risk (RR and 95% confidence interval (CI)) of subsequent fracture in a later age category was compared between those with prior fracture and those without.
  
  
  RESULTS
  For both sexes, childhood fracture increased the risk of subsequent fracture in adolescence (males: RR 21.7; 95% CI 16.0, 27.4; females: RR 8.1; 3.5, 12.8). Males with adolescent fracture had increased risk of subsequent fracture in early adulthood (RR 11.5; 5.7, 17.3) and mid-adulthood (RR 13.0; 6.3, 19.7). Additionally, males with young adulthood or mid-adulthood fracture had increased risk of subsequent fracture in the following age group (RR 11.2; 4.4, 17.9, and RR 6.2; 0.8, 11.7, respectively). Mid-adult fractures increased the risk of subsequent fracture in older adulthood (RR 6.2; 0.8, 11.7). Females with childhood or adolescent fracture had an increased risk of fracture in young adulthood (RR 4.3; 0.7, 7.9, and RR 10.5; 4.4, 16.6), and prior fracture in older adult life increased the risk of subsequent fracture in old age (RR 14.9; 6.4. 23.3).
  
  
  CONCLUSIONS
  Fracture prevention strategies may be more effective if attention is directed towards individuals with prior fracture at any age as they have a higher likelihood of sustaining a subsequent fracture later in life.
authors.affiliation: School of Medicine, Deakin University, 285 Ryrie Street, Geelong, VIC, 3220, Australia, KHOLLO@BarwonHealth.org.au.
authors.forename: K L
authors.initials: KL
authors.lastname: Holloway
authors.forename: S L
authors.initials: SL
authors.lastname: Brennan
authors.forename: M A
authors.initials: MA
authors.lastname: Kotowicz
authors.forename: G
authors.initials: G
authors.lastname: Bucki-Smith
authors.forename: E N
authors.initials: EN
authors.lastname: Timney
authors.forename: A G
authors.initials: AG
authors.lastname: Dobbins
authors.forename: L J
authors.initials: LJ
authors.lastname: Williams
authors.forename: J A
authors.initials: JA
authors.lastname: Pasco
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D017678:Sex Distribution; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult