Risk and Adverse Outcomes of Fractures in Patients with Liver Cirrhosis: Two Nationwide Retrospective Cohort Studies

Overview

Journal BMJ Open

Specialty General Medicine

Date 2017 Oct 11

PMID 28993387

Citations 11

Authors

Ta-Liang Chen

Chao-Shun Lin

Chun-Chuan Shih

Yu-Feng Huang

Chun-Chieh Yeh

Chih-Hsing Wu

Yih-Giun Cherng

Chien-Chang Liao

Affiliations

Soon will be listed here.

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.

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