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Acute and long-term increase in fracture risk after hospitalization for stroke.

https://arctichealth.org/en/permalink/ahliterature195446
Source
Stroke. 2001 Mar;32(3):702-6
Publication Type
Article
Date
Mar-2001
Author
J. Kanis
A. Oden
O. Johnell
Author Affiliation
Center for Metabolic Bone Diseases (World Health Organization Collaborating Center), University of Sheffield Medical School (UK). w.j.pontefract@sheffield.ac.uk
Source
Stroke. 2001 Mar;32(3):702-6
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Female
Follow-Up Studies
Fractures, Bone - epidemiology
Hip Fractures - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Poisson Distribution
Proportional Hazards Models
Risk
Risk Assessment - statistics & numerical data
Sex Distribution
Stroke - epidemiology - therapy
Sweden - epidemiology
Time
Abstract
The aims of this study were to determine the magnitude of the increase in fracture risk after hospitalization for stroke, and in particular to determine the time course of this risk.
The records of the Swedish register of patients admitted during 1987-1996 were examined to identify all patients who were admitted to the hospital for stroke. Patients were followed for subsequent hospitalizations for hip and all fractures combined. We analyzed 16.3 million hospitalizations, from which 273 288 individuals with stroke were identified. A Poisson model was used to determine the absolute risk of subsequent fractures and the risk compared with that of the general population.
After hospitalization for stroke, there was a >7-fold increase in fracture risk, including that for hip fracture within the first year after hospitalization for stroke. Thereafter, fracture risk declined toward, but did not attain, the baseline risk except in men and women aged >/=80 years.
The high incidence of new fractures within the first year of hospitalization for stroke suggests that such patients should be preferentially targeted for treatment. It is possible that short courses of treatment at the time of stroke would provide important therapeutic dividends.
PubMed ID
11239190 View in PubMed
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Acute and long-term increase in fracture risk after hospitalization for vertebral fracture.

https://arctichealth.org/en/permalink/ahliterature194968
Source
Osteoporos Int. 2001;12(3):207-14
Publication Type
Article
Date
2001
Author
O. Johnell
A. Oden
F. Caulin
J A Kanis
Author Affiliation
Department of Orthopaedics, Malmö General Hospital, Malmö, Sweden.
Source
Osteoporos Int. 2001;12(3):207-14
Date
2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Chronic Disease
Cross-Sectional Studies
Female
Hip Fractures - epidemiology
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Osteoporosis - complications
Poisson Distribution
Risk factors
Spinal Fractures - epidemiology
Sweden - epidemiology
Abstract
The aims of this study were to determine the magnitude of the increase in risk of further fracture following hospitalization for vertebral fracture, and in particular to determine the time course of this risk. The records of the Swedish Patient Register were examined from 1987 to 1994 to identify all patients who were admitted to hospital for thoracic or lumbar vertebral fractures. Vertebral fractures were characterized as due to high- or low-energy trauma. Patients were followed for subsequent hospitalizations for hip fracture, and for all fractures combined. A Poisson model was used to determine the absolute risk of subsequent nonvertebral fracture and compared with that of the general population. We analyzed 13.4 million hospital admissions from which 28,869 individuals with vertebral fracture were identified, of which 60% were associated with low-energy trauma. There was a marked increase in subsequent incidence of hip and all fractures within the first year following hospitalization for vertebral fracture in both men and women. Thereafter, fracture incidence declined toward, but did not attain, baseline risk. Increased risks were particularly marked in the young. The increase in fracture risk was more marked following low-energy vertebral fracture than in the case of high-energy trauma. We conclude that the high incidence of new fractures within a year of hospitalization for vertebral fractures, irrespective of the degree of trauma involved, indicates that such patients should be preferentially targeted for treatment. It is speculated that short courses of treatment at the time of first vertebral fracture could provide important therapeutic dividends.
PubMed ID
11315239 View in PubMed
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Age and sex patterns of hip fracture--changes in 30 years.

https://arctichealth.org/en/permalink/ahliterature240424
Source
Acta Orthop Scand. 1984 Jun;55(3):290-2
Publication Type
Article
Date
Jun-1984
Author
O. Johnell
B. Nilsson
K. Obrant
I. Sernbo
Source
Acta Orthop Scand. 1984 Jun;55(3):290-2
Date
Jun-1984
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Female
Femoral Neck Fractures - epidemiology
Hip Fractures - epidemiology
Humans
Male
Middle Aged
Risk
Sex Factors
Sweden
Abstract
The age- and sex-specific incidence of hip fractures was studied over a period of 30 years. There was a continuous increase in incidence over the years. The trend was most obvious in the oldest age groups and in men.
PubMed ID
6741476 View in PubMed
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An estimate of the worldwide prevalence, mortality and disability associated with hip fracture.

https://arctichealth.org/en/permalink/ahliterature70881
Source
Osteoporos Int. 2004 Nov;15(11):897-902
Publication Type
Article
Date
Nov-2004
Author
O. Johnell
J A Kanis
Author Affiliation
Department of Orthopaedics, Malmo General Hospital, Malmo, Sweden.
Source
Osteoporos Int. 2004 Nov;15(11):897-902
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Aged
Cost of Illness
Developed Countries
Disability Evaluation
Female
Hip Fractures - epidemiology - etiology - mortality
Humans
Incidence
Male
Middle Aged
Morbidity
Osteoporosis - complications - epidemiology - mortality
Prevalence
Quality-Adjusted Life Years
Research Support, Non-U.S. Gov't
Sex Distribution
Survival Analysis
World Health
Abstract
The aim of this study was to quantify the global burden of osteoporosis as judged by hip fracture and the burden in different socio-economic regions of the world. The population mortality in 1990 and the incidence of hip fracture in different regions were identified, where possible in 1990. Excess mortality from hip fracture used data for Sweden, and disability weights were assigned to survivors from hip fracture. In 1990 there were an estimated 1.31 million new hip fractures, and the prevalence of hip fractures with disability was 4.48 million. There were 740,000 deaths estimated to be associated with hip fracture. There were 1.75 million disability adjusted life-years lost, representing 0.1% of the global burden of disease world-wide and 1.4% of the burden amongst women from the established market economies. We conclude that hip fracture is a significant cause of morbidity and mortality worldwide.
PubMed ID
15490120 View in PubMed
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Are the findings in the Swedish National Total Hip Arthroplasty Register valid? A comparison between the Swedish National Total Hip Arthroplasty Register, the National Discharge Register, and the National Death Register.

https://arctichealth.org/en/permalink/ahliterature14074
Source
J Arthroplasty. 2000 Oct;15(7):884-9
Publication Type
Article
Date
Oct-2000
Author
P. Söderman
H. Malchau
P. Herberts
O. Johnell
Author Affiliation
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Source
J Arthroplasty. 2000 Oct;15(7):884-9
Date
Oct-2000
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - mortality - statistics & numerical data
Comparative Study
Female
Humans
Male
Osteoarthritis - surgery
Registries - standards
Reoperation
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
The Swedish National Total Hip Arthroplasty (THA) Register was initiated in 1979, and it is one of the oldest quality registers in the world. The register covers all hospitals in Sweden, and today it contains > 205,000 hip arthroplasties. The failure endpoint definition in the register is revision. There is no information about quality of life and mortality. The aim of this study was to validate the results presented by the Swedish THA register by comparison with the Discharge register (the Swedish National Board of Health and Welfare) and to study mortality after hip arthroplasties. All hip arthroplasties from the Discharge register, performed in 1986 and thereafter, were compared with the Swedish THA register. Epidemiologic parameters, including mortality, were documented from the Swedish Death register. The mortality for primary THAs for men was 1% higher and for women 6% higher when compared with an age-matched and sex-matched cohort. For revision, the numbers were 7% and 9% higher. The risk for death compared with an age-matched and sex-matched population was lower for patients with osteoarthrosis treated with hip arthroplasty. The results with revision as failure endpoint showed that the Swedish THA register is reliable. The register includes >95% of the primary and revision THAs performed in Sweden between 1986 and 1995.
PubMed ID
11061449 View in PubMed
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Assessment of sex hormones and bone mineral density in relation to occurrence of fracture in men: a prospective population-based study.

https://arctichealth.org/en/permalink/ahliterature10932
Source
Bone. 1998 Feb;22(2):147-51
Publication Type
Article
Date
Feb-1998
Author
F. Nyquist
P. Gärdsell
I. Sernbo
J O Jeppsson
O. Johnell
Author Affiliation
Department of Orthopaedics, Malmö University Hospital, Lund University, Sweden.
Source
Bone. 1998 Feb;22(2):147-51
Date
Feb-1998
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Drinking - blood
Alcoholism - blood
Biological Markers - blood
Bone Density
Forearm
Fractures, Bone - epidemiology - etiology
Hip Fractures - epidemiology
Humans
Longitudinal Studies
Male
Middle Aged
Osteoporosis - complications - epidemiology
Predictive value of tests
Sex Hormone-Binding Globulin - analysis
Skinfold thickness
Sweden - epidemiology
Testosterone - blood
Transferrin - analogs & derivatives - analysis
Abstract
Patients with fragility fractures have low bone mineral density (BMD)--this statement is supported mainly by data on women. In this study, including only men, the objectives were to determine whether a decline in BMD alone or in combination with data on male sex hormones and skinfold thickness could be of value in predicting forthcoming fractures. We also wanted to find out whether high consumers of alcohol can be identified by measuring BMDs and male sex hormones. A prospective, population-based study was performed in the city of Malmö, Sweden. 242 men were randomly selected; all were of Scandinavian ethnic background, and were aged 50, 60, 70, and 80 years. Forearm BMD, testosterone, sex-hormone-binding globulin (SHBG), and skinfold thickness were analyzed. In addition, alcohol consumption and carbohydrate-deficient transferrin (CDT)--a marker of alcohol abuse--were analyzed. The study group was followed prospectively for 7 years and all fractures sustained were recorded. Prospectively, for a 1 SD decrease in forearm BMD, the Cox proportional hazard model gave a relative risk (RR) of 1.75 with a 95% confidence interval of 1.08-2.83 for a forthcoming fracture and 3.88 (1.30-11.57) for a hip fracture. For a 1 SD change in skinfold thickness, measured on the dorsum of the hand, a RR of 1.69 (0.99-2.87) for a forthcoming fracture was found and the corresponding value for hip fracture was 2.34 (1.10-5.00). Testosterone and SHBG did not enhance fracture prediction. Abusers of alcohol had, retrospectively, significantly more fractures. Individuals with alcohol consumption rates in the highest quartile had significantly higher CDT levels, but we were unable to identify high consumers of alcohol by analyzing BMD or sex hormones. In this study we found that forearm BMD and skinfold thickness could be used in predicting forthcoming fractures in men.
PubMed ID
9477238 View in PubMed
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Background factors in patients with hip fractures--differences between cervical and trochanteric fractures.

https://arctichealth.org/en/permalink/ahliterature234810
Source
Compr Gerontol A. 1987 Sep;1(3):109-11
Publication Type
Article
Date
Sep-1987
Author
I. Sernbo
O. Johnell
Author Affiliation
Department of Orthopaedics, Malmö General Hospital, Lund University, Sweden.
Source
Compr Gerontol A. 1987 Sep;1(3):109-11
Date
Sep-1987
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Female
Femoral Neck Fractures
Hip Fractures
Humans
Male
Middle Aged
Recurrence
Retrospective Studies
Risk factors
Sex Factors
Sweden
Abstract
Comparisons were made between 133 men with cervical fractures and 151 men with trochanteric fractures and 308 women with cervical fractures and 449 women with trochanteric fractures. All patients with hip fractures were studied consecutively and prospectively. Patients were interviewed a few days after admission and their medical records studied. We found great differences in background factors between patients with cervical and trochanteric fractures but these differences seemed to depend largely on age. In an age-matched material we find that patients with trochanteric fractures are more prone to such fragility fractures as vertebral fracture, trochanteric fracture and fracture of the upper end of the humerus. This could mean that trochanteric fractures occur in bone of lower trabecular mass.
PubMed ID
3453291 View in PubMed
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Balance and gait performance in an urban and a rural population.

https://arctichealth.org/en/permalink/ahliterature72646
Source
J Am Geriatr Soc. 1998 Jan;46(1):65-70
Publication Type
Article
Date
Jan-1998
Author
K A Ringsberg
P. Gärdsell
O. Johnell
B. Jónsson
K J Obrant
I. Sernbo
Author Affiliation
Department of Orthopaedics, Malmö University Hospital, Lund University, Sweden.
Source
J Am Geriatr Soc. 1998 Jan;46(1):65-70
Date
Jan-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
Comparative Study
Cross-Sectional Studies
Female
Gait
Health status
Humans
Leisure Activities
Male
Middle Aged
Musculoskeletal Equilibrium
Research Support, Non-U.S. Gov't
Rural Population
Sweden
Urban Population
Work
Abstract
OBJECTIVE: To compare the differences in standing balance and gait performance between two populations, correlated with age and physical activities of daily living. DESIGN: A cross-sectional study. SETTINGS: Malmö, the third largest city in Sweden, and Sjöbo, a typical agricultural community 60 km east of Malmö. PARTICIPANTS: Participants were 570 men and women from the urban community (urban) and 391 from the rural community (rural), born in 1938, 1928, 1918, and 1908, and women born in 1948. The two cohorts were subdivided into true urbans, who had lived only in the city (n = 269), and true rurals, who had never lived in a city (n = 354). MEASUREMENTS: Information about workload, housing, spare time activities, medication, and illness during different decades of life was gathered using two questionnaires. The first questionnaire was sent to the home after agreement to participate, and the second was presented at the test session. The clinical measurements were standing balance, gait speed, and step length. RESULTS: The urban subjects had significantly (P
PubMed ID
9434667 View in PubMed
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Bone mass in an urban and a rural population: a comparative, population-based study in southern Sweden.

https://arctichealth.org/en/permalink/ahliterature73685
Source
J Bone Miner Res. 1991 Jan;6(1):67-75
Publication Type
Article
Date
Jan-1991
Author
P. Gärdsell
O. Johnell
B E Nilsson
I. Sernbo
Author Affiliation
Department of Orthopaedics, Malmö General Hospital, Lund University, Sweden.
Source
J Bone Miner Res. 1991 Jan;6(1):67-75
Date
Jan-1991
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Bone Density - physiology
Comparative Study
Female
Hip Fractures - epidemiology - physiopathology
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Rural Health
Sweden
Urban health
Abstract
Several previous studies have reported regional differences in the incidence of hip fractures. A population-based study was performed in the city of Malmö (urban population) and in the municipality of Sjöbo (rural population), 60 km apart. A total of 961 men and women, randomly selected and of Scandinavian ethnic background, participated in the study. Bone mineral content (BMC) of the forearm was measured with single-photon absorptiometry (SPA). Women and men in the city had significantly lower BMC compared with the rural population. The differences were even more pronounced when comparing a true urban population (lived their entire life in a city) with a true rural population (never lived in a city). The differences in BMC between Malmö and Sjöbo were more obvious in men. These data suggest that differences in bone mass between an urban and a rural population could to some extent explain differences in fracture incidence.
Notes
Erratum In: J Bone Miner Res 1991 Apr;6(4):428
PubMed ID
1863289 View in PubMed
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Bone mineral density assessed by quantitative ultrasound and dual energy X-ray absorptiometry. Normative data in Malmö, Sweden.

https://arctichealth.org/en/permalink/ahliterature205575
Source
Acta Orthop Scand. 1998 Apr;69(2):189-93
Publication Type
Article
Date
Apr-1998
Author
M K Karlsson
K J Obrant
B E Nilsson
O. Johnell
Author Affiliation
Department of Orthopedics, Malmö University Hospital, Sweden.
Source
Acta Orthop Scand. 1998 Apr;69(2):189-93
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adult
Aged
Aged, 80 and over
Bone Density
Bone and Bones - ultrasonography
Female
Humans
Male
Middle Aged
Reference Values
Regression Analysis
Sweden
Abstract
We measured bone mineral density (BMD) in 128 men and 143 women, aged 22-90, by dual energy X-ray absorptiometry (DEXA) and quantitative ultrasound (QUS). We found reduced bone mineral density in relation to age as measured both by DEXA and QUS. There was a correlation between 0.28 and 0.52 in men and between 0.53 and 0.77 in women when comparing DEXA and QUS measurements. When including only persons with low bone mass, the correlation was less.
PubMed ID
9602782 View in PubMed
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70 records – page 1 of 7.