Articles producció científica> Ciències Mèdiques Bàsiques

Differential Mortality and the Excess Rates of Hip Fracture Associated With Type 2 Diabetes: Accounting for Competing Risks in Fracture Prediction Matters.

  • Identification data

    Identifier: imarina:3416039
    Authors:
    Tebé C, Martinez-Laguna D, Moreno V, Cooper C, Diez-Perez A, Collins GS, Prieto-Alhambra D
    Abstract:
    © 2018 American Society for Bone and Mineral Research. Type 2 diabetes (T2DM) is associated with a reduced life expectancy. The latest published evidence suggests an increased risk of fractures among T2DM patients. We conducted a population-based cohort study to determine the impact of mortality as a competing risk in the study of the association between T2DM and hip fracture rates. Participants were all diagnosed T2DM patients registered in the Sistema de Información para el Desarrollo de la Investigación en Atención Primaria (SIDIAP) database aged 65 years and older; up to two non-T2DM were matched by age, sex, and primary care facility. We used Cox regression models to estimate cause-specific hazard ratio (HR) of death or hip fracture according to T2DM status. Fine and Gray models were then fitted to estimate the subhazard ratio (SHR) of hip fracture while accounting for competing risk with death and to estimate the probability of hip fracture within 5 years. A total of 55,891 T2DM and 103,093 matched non-T2DM patients were observed for a median of 8 years. Mortality was 48.8 per 1000 person years (py) in T2DM, and 33.8 per 1000 py in non-T2DM; hip fracture rates were 6.0 per 1000 py and 4.9 per 1000 py, respectively. Cox models confirmed a significant association for death and hip fracture: HR 1.51 (95% CI, 1.48 to 1.55), and HR 1.32 (95% CI, 1.24 to 1.40), respectively. Accounting for death as a competing event (Fine-Gray models), the association between T2DM and hip fracture risk remained statistically significant (SHR 1.15; 95% CI, 1.09 to 1.21) and the probability of a hip fracture within 5 years was 2.3% for TD2M and 1.9% for non-TD2M patients compared to 2.6% and 2.1% respectively using Kaplan-Meier (KM) estimates. T2DM patients have a 50% increased mortality
  • Others:

    Author, as appears in the article.: Tebé C, Martinez-Laguna D, Moreno V, Cooper C, Diez-Perez A, Collins GS, Prieto-Alhambra D
    Department: Ciències Mèdiques Bàsiques
    URV's Author/s: TEBÉ CORDOMÍ, CRISTIAN
    Keywords: @infoAeu @residentesaeu @uroweb Etiqueta «#» Hashtag
    Abstract: © 2018 American Society for Bone and Mineral Research. Type 2 diabetes (T2DM) is associated with a reduced life expectancy. The latest published evidence suggests an increased risk of fractures among T2DM patients. We conducted a population-based cohort study to determine the impact of mortality as a competing risk in the study of the association between T2DM and hip fracture rates. Participants were all diagnosed T2DM patients registered in the Sistema de Información para el Desarrollo de la Investigación en Atención Primaria (SIDIAP) database aged 65 years and older; up to two non-T2DM were matched by age, sex, and primary care facility. We used Cox regression models to estimate cause-specific hazard ratio (HR) of death or hip fracture according to T2DM status. Fine and Gray models were then fitted to estimate the subhazard ratio (SHR) of hip fracture while accounting for competing risk with death and to estimate the probability of hip fracture within 5 years. A total of 55,891 T2DM and 103,093 matched non-T2DM patients were observed for a median of 8 years. Mortality was 48.8 per 1000 person years (py) in T2DM, and 33.8 per 1000 py in non-T2DM; hip fracture rates were 6.0 per 1000 py and 4.9 per 1000 py, respectively. Cox models confirmed a significant association for death and hip fracture: HR 1.51 (95% CI, 1.48 to 1.55), and HR 1.32 (95% CI, 1.24 to 1.40), respectively. Accounting for death as a competing event (Fine-Gray models), the association between T2DM and hip fracture risk remained statistically significant (SHR 1.15; 95% CI, 1.09 to 1.21) and the probability of a hip fracture within 5 years was 2.3% for TD2M and 1.9% for non-TD2M patients compared to 2.6% and 2.1% respectively using Kaplan-Meier (KM) estimates. T2DM patients have a 50% increased mortality and, after adjusting for differential survival at 5 years, a 21% increased incidence of hip fracture when compared to matched non-T2DM. Failing to account for differential mortality leads to an overestimation of fracture risk.
    Thematic Areas: Endocrinology & Metabolism Endocrinology, Diabetes and Metabolism Orthopedics and Sports Medicine
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: cristian.tebe@urv.cat
    ISSN: 08840431
    Author identifier: 0000-0003-2320-1385
    Record's date: 2020-07-16
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.3435
    Papper original source: JOURNAL OF BONE AND MINERAL RESEARCH. (ISSN/ISBN: 08840431). 33(8): 1417-1421
    APA: Tebé C, Tebé C, Tebé C, Martinez-Laguna D, Martinez-Laguna D, Moreno V, Moreno V, Cooper C, Cooper C, Diez-Perez A, Collins GS, Collins GS, Prieto-Alhambra D, Prieto-Alhambra D, Prieto-Alhambra D (2018). Differential mortality and the excess rates of hip fracture associated with type 2 diabetes: accounting for competing risks in fracture prediction matters.. JOURNAL OF BONE AND MINERAL RESEARCH, (), -. DOI: 10.1002/jbmr.3435
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1002/jbmr.3435
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2018
    Publication Type: Journal Publications
  • Keywords:

    Endocrinology & Metabolism,Endocrinology, Diabetes and Metabolism,Orthopedics and Sports Medicine
    @infoAeu
    @residentesaeu
    @uroweb
    Etiqueta «#»
    Hashtag
    Endocrinology & Metabolism
    Endocrinology, Diabetes and Metabolism
    Orthopedics and Sports Medicine
    08840431
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