The University of Southampton
University of Southampton Institutional Repository

Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women

Gelhbach, Stephen, Saag, Kenneth .G., Adachi, Jonathan D., Hooven, Fred H., Flahvie, Julie, Boonen, Steven, Chapurlat, Roland D., Compston, Juliet E., Cooper, Cyrus, Diez-Perez, Adolfo, Greenspan, Susan L., LaCroix, Andrea Z., Netelenbos, J. Coen, Pfeilschifter, Johannes, Rossini, Maurizio, Roux, Christian, Sambrook, Philip N., Silverman, Stuart, Siris, Ethel S., Watts, Nelson B. and Lindsay, Robert (2012) Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women Journal of Bone and Mineral Research, 27, (3), pp. 645-653. (doi:10.1002/jbmr.1476). (PMID:22113888).

Record type: Article


Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women aged ?55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ?3 fractures, respectively, since age 45 years. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no previous fractures, women with 1, 2, or ?3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ?3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio [HR]?=?7.3) and hip (HR?=?3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, and previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture. Women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development.

Full text not available from this repository.

More information

e-pub ahead of print date: 21 February 2012
Published date: March 2012
Keywords: women, fracture, osteoporosis, predictor
Organisations: Faculty of Health Sciences


Local EPrints ID: 340467
ISSN: 0884-0431
PURE UUID: 33c3ea6f-0bc5-4eda-b2e0-e8c381ac9e4f
ORCID for Cyrus Cooper: ORCID iD

Catalogue record

Date deposited: 22 Jun 2012 11:02
Last modified: 18 Jul 2017 05:44

Export record



Author: Stephen Gelhbach
Author: Kenneth .G. Saag
Author: Jonathan D. Adachi
Author: Fred H. Hooven
Author: Julie Flahvie
Author: Steven Boonen
Author: Roland D. Chapurlat
Author: Juliet E. Compston
Author: Cyrus Cooper ORCID iD
Author: Adolfo Diez-Perez
Author: Susan L. Greenspan
Author: Andrea Z. LaCroix
Author: J. Coen Netelenbos
Author: Johannes Pfeilschifter
Author: Maurizio Rossini
Author: Christian Roux
Author: Philip N. Sambrook
Author: Stuart Silverman
Author: Ethel S. Siris
Author: Nelson B. Watts
Author: Robert Lindsay

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.