Table 3.
Fracture incidence rate ratio* (and 95% confidence interval) for predisposing factors, by type of fracture; Medicare beneficiaries, 2000–2005
| Site of Incident Fracture |
||||||
|---|---|---|---|---|---|---|
| Variable | Hip | Spine | Distal Radius/Ulna | Humerus | Ankle | Tibia/Fibula |
| PREVIOUS FRACTURI | ||||||
| Distal Radius/Ulna | 1.46 (1.39, 1.54) | 1.37 (1.29, 1.45) | -† | 1.74 (1.61, 1.88) | 1.50 (1.34, 1.68) | 1.44 (1.24, 1.67) |
| Other Radius/Ulna | 1.21 (1.09, 1.35) | 1.25 (1.11, 1.4) | 1.29 (1.08, 1.55) | 1.74 (1.48, 2.04) | 1.56 (1.26, 1.94) | 1.47 (1.11, 1.95) |
| Carpal Bones | 1.08 (0.88, 1.34) | 1.24 (1.00, 1.55) | 1.92 (1.38, 2.67) | 1.27 (0.93, 1.73) | 0.88 (0.52, 1.48) | 1.28 (0.74, 2.22) |
| Humerus | 1.81 (1.72, 1.90) | 1.75 (1.65, 1.86) | 1.57 (1.44, 1.71) | -† | 1.27 (1.11, 1.46) | 1.75 (1.50, 2.04) |
| Clavicle | 1.56 (1.36, 1.78) | 1.99 (1.72, 2.30) | 1.71 (1.37, 2.14) | 2.16 (1.75, 2.67) | 1.17 (0.79, 1.73) | 1.71 (1.15, 2.54) |
| Spine, Closed | 1.63 (1.56, 1.69) | -† | 1.38 (1.28, 1.49) | 1.58 (1.47, 1.70) | 1.12 (0.99, 1.26) | 1.58 (1.38, 1.81) |
| Spine, Other | 1.17 (1.05, 1.30) | -† | 0.91 (0.73, 1.14) | 1.26 (1.04, 1.51) | 0.95 (0.67, 1.35) | 1.11 (0.76, 1.61) |
| Pelvis | 1.59 (1.49, 1.69) | 1.87 (1.74, 2.01) | 1.30 (1.15, 1.46) | 1.40 (1.25, 1.58) | 1.19 (0.98, 1.43) | 1.63 (1.35, 1.97) |
| Hip | -† | 1.48 (1.42, 1.54) | 1.33 (1.25, 1.41) | 1.49 (1.40, 1.58) | 0.86 (0.77, 0.95) | 1.75 (1.58, 1.93) |
| Femur | 1.31 (1.17, 1.47) | 1.23 (1.10, 1.38) | 1.15 (0.98, 1.36) | 1.12 (0.94, 1.34) | 1.73 (1.40, 2.13) | 4.37 (3.70, 5.15) |
| Tibia/Fibula | 1.33 (1.19, 1.47) | 1.25 (1.11, 1.42) | 1.32 (1.11, 1.56) | 1.20 (0.99, 1.46) | 1.70 (1.35, 2.14) | -† |
| Ankle | 0.99 (0.91, 1.08) | 1.14 (1.04, 1.25) | 1.27 (1.12, 1.43) | 0.96 (0.82, 1.11) | -† | 2.60 (2.19, 3.09) |
| OTHER PREDISPOSING CONDITIONS‡ | ||||||
| Glucocorticoid-related | 1.20 (1.18, 1.22) | 1.47 (1.44, 1.50) | 1.09 (1.06, 1.12) | 1.16 (1.13, 1.20) | 1.05 (1.02, 1.09) | 1.15 (1.09, 1.21) |
| Diabetes | 1.01 (0.99, 1.02) | 0.98 (0.96, 1.00) | 0.95 (0.93, 0.98) | 1.22 (1.18, 1.26) | 1.35 (1.30, 1.39) | 1.15 (1.09, 1.21) |
| Fall-Related | 1.70 (1.67, 1.74) | 1.53 (1.50, 1.57) | 1.24 (1.20, 1.27) | 1.43 (1.38, 1.48) | 1.27 (1.22, 1.32) | 1.39 (1.31, 1.47) |
| Renal Disease | 1.20 (1.17, 1.23) | 1.05 (1.02, 1.08) | 1.00 (0.96, 1.05) | 1.11 (1.06, 1.16) | 1.09 (1.02, 1.15) | 1.18 (1.09, 1.27) |
| Depressive Illness | 1.45 (1.43, 1.48) | 1.25 (1.22, 1.28) | 1.23 (1.20, 1.27) | 1.27 (1.23, 1.32) | 1.25 (1.20, 1.30) | 1.33 (1.25, 1.40) |
| AMI | 1.06 (1.04, 1.09) | 1.03 (1.00, 1.06) | 1.01 (0.97, 1.06) | 1.05 (1.00, 1.10) | 1.02 (0.96, 1.08) | 1.00 (0.92, 1.09) |
| Other Heart Disease | 1.10 (1.08, 1.12) | 1.18 (1.15, 1.20) | 0.98 (0.95, 1.00) | 1.06 (1.03, 1.10) | 1.09 (1.05, 1.13) | 1.12 (1.06, 1.18) |
| Bone Disease | 1.01 (0.98, 1.05) | 1.12 (1.07, 1.16) | 1.07 (1.01, 1.13) | 1.00 (0.94, 1.07) | 1.02 (0.94, 1.10) | 1.04 (0.93, 1.16) |
| Cancer | 1.08 (1.07, 1.10) | 1.22 (1.20, 1.25) | 1.05 (1.02, 1.08) | 1.12 (1.09, 1.16) | 1.05 (1.01, 1.09) | 1.03 (0.98, 1.09) |
*
Rate ratios for each variable are adjusted for all other variables included in Tables 2 and 3.
†
Rate ratio not computed: by design, the cohort for each incident fracture site excluded beneficiaries with a history of that fracture site.
‡
Conditions included in each category, with accompanying ICD-9 codes, are listed in the Appendix.