Table 2.

Crude and adjusted hazard ratios for the association between DOACs and the risk of fracture

Exposure	Events	Person-years	Incidence rate a	Crude HR	Adjusted HRb (95% CI)
All fracture
VKA (≥180 days)	183	11 930	15.3	1.00 (Ref)	1.00 (Reference)
DOAC (≥180 days)	43	5709	7.5	0.49	0.65 (0.46–0.91)
VKA (<180 days)	126	8001	15.7	1.00	0.79 (0.52–1.19)
DOAC (<180 days)	55	4862	11.3	0.71	0.86 (0.52–1.43)
Multiple use	57	4749	12.0	0.78	0.73 (0.52–1.03)
Hip fracture
VKA (≥180 days)	103	11 930	8.6	1.00 (Ref)	1.00 (Reference)
DOAC (≥180 days)	18	5709	3.2	0.36	0.51 (0.31–0.86)
VKA (<180 days)	66	8001	8.2	0.98	0.90 (0.52–1.55)
DOAC (<180 days)	24	4862	4.9	0.59	0.80 (0.40–1.62)
Multiple use	34	4749	7.2	0.84	0.82 (0.53–1.27)
Upper extremity fracture
VKA (≥180 days)	27	11 930	2.3	1.00 (Ref)	1.00 (Reference)
DOAC (≥180 days)	16	5709	2.8	1.24	1.37 (0.73–2.57)
VKA (<180 days)	26	8001	3.2	1.76	1.04 (0.42–2.58)
DOAC (<180 days)	17	4862	3.5	1.90	1.95 (0.68–5.55)
Multiple use	10	4749	2.1	0.96	1.05 (0.52–2.11)
Vertebral fracture
VKA (≥180 days)	32	11 930	2.7	1.00 (Ref)	1.00 (Reference)
DOAC (≥180 days)	7	5709	1.2	0.46	0.62 (0.27–1.45)
VKA (<180 days)	21	8001	2.6	0.76	0.51 (0.15–1.82)
DOAC (<180 days)	10	4862	2.1	0.59	0.52 (0.15–1.77)
Multiple use	6	4749	1.3	0.46	0.34 (0.12–1.01)
Other fracturec
VKA (≥180 days)	21	11 930	1.8	1.00 (Ref)	1.00 (Reference)
DOAC (≥180 days)	<5 d	–	0.4	0.21	0.24 (0.06–1.00)
VKA (<180 days)	13	8001	1.6	0.45	0.25 (0.06–1.11)
DOAC (<180 days)	<5 d	–	0.8	0.22	0.22 (0.03–1.60)
Multiple use	7	4749	1.5	0.71	0.41 (0.13–1.31)

CI, confidence interval; DOAC, direct oral anticoagulant; HR, hazard ratio; VKA, vitamin-K antagonist.

^aPer 1000 person-years.

^bPropensity score fine stratification and weighting was used for adjustment.

^cOsteoporosis with pathological fracture, defined as ICD-10 code M80.

^dCells with less than five events were suppressed owing to privacy restrictions.