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. 2016 Jul 27;354:i3794. doi: 10.1136/bmj.i3794

Table 4.

Relative risks of fracture between groups by fracture site and period

Groups Period before surgery (or index date) Period after surgery (or index date)
Unadjusted RR (95% CI) Adjusted RR* (95% CI) Unadjusted RR (95% CI) Adjusted RR* (95% CI)
Distal lower limb (knee, foot, ankle, and tibia/fibula)
Bariatric group (n=12 676) 2.15 (1.99 to 2.32) 1.71 (1.57 to 1.85) 1.47 (1.26 to 1.72) 1.15 (0.98 to 1.35)
Obese group (n=38 028) 1.46 (1.38 to 1.55) 1.43 (1.35 to 1.52) 1.30 (1.18 to 1.44) 1.21 (1.09 to 1.34)
Non-obese group (n=126 760) Reference Reference Reference Reference
P value† <0.001 <0.001 <0.001 0.001
Clinical spine
Bariatric group (n=12 676) 1.33 (0.97 to 1.82) 0.81 (0.58 to 1.13) 2.14 (1.40 to 3.28) 1.70 (1.06 to 2.73)
Obese group (n=38 028) 0.96 (0.77 to 1.20) 0.88 (0.70 to 1.11) 1.03 (0.70 to 1.52) 1.00 (0.68 to 1.49)
Non-obese group (n=126 760) Reference Reference Reference Reference
P value† 0.25 0.31 0.03 0.15
Pelvis, hip, and femur
Bariatric group (n=12 676) 1.76 (1.30 to 2.38) 1.08 (0.78 to 1.49) 3.12 (2.35 to 4.14) 1.88 (1.37 to 2.58)
Obese group (n=38 028) 1.16 (0.94 to 1.44) 1.05 (0.84 to 1.31) 1.11 (0.84 to 1.47) 0.90 (0.67 to 1.21)
Non-obese group (n=126 760) Reference Reference Reference Reference
P value† 0.009 0.84 <0.001 0.001
Upper limb (shoulder, humerus, elbow, forearm, and wrist)
Bariatric group (n=12 676) 1.11 (1.00 to 1.23) 0.89 (0.80 to 1.00) 2.03 (1.77 to 2.34) 1.65 (1.42 to 1.91)
Obese group (n=38 028) 0.96 (0.90 to 1.03) 0.93 (0.87 to 1.00) 0.95 (0.84 to 1.08) 0.90 (0.80 to 1.02)
Non-obese group (n=126 760) Reference Reference Reference Reference
P value† 0.07 0.04 <0.001 <0.001

RR=relative risk.

*Adjusted for duration of follow-up, material and social deprivation, area of residence, history of fracture (period after index date only), and number of comorbidities in previous five years, using multivariate conditional Poisson regression model.

†Type III P value for group variable.