Increased Risk of Hip, Wrist Fracture in Patients With Cirrhosis: Presented at AASLD

By Cheryl Lathrop

BOSTON -- November 3, 2010 -- Studying a representative population, patients with cirrhosis were found to be at a considerably higher risk for hip and wrist fracture than age- and sex-matched controls in the general population, according to results presented here at the 61st Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).

Joe West, PhD, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom, and colleagues reported findings from their study at the poster session here on November 1.

While numerous studies have shown an association between chronic liver disease and osteoporosis, few have accurately documented the risks of osteoporotic fracture in these patients and none have compared incidence rates to the general population.

The researchers undertook a UK population-based study using the General Practice Research Database (GPRD) to quantify the excess fracture risk in people with cirrhosis.

The researchers obtained all records of patients with a diagnostic or therapeutic code for cirrhosis, oesophageal varices, and/or portal hypertension within the GPRD between June 1987 and April 2002, as well as records of up to 10 age-, sex-, and practice-matched controls for each.

A total of 4,787 patients with cirrhosis and 46,789 matched patients without cirrhosis were included in the study.

Patients with cirrhosis had a higher hazard of hip and wrist fracture. Patients with alcoholic cirrhosis had a higher hazard ratio for fracture than those with non-alcoholic cirrhosis (however, this is mediated by the increased risk of fracture in the older control population of non-alcoholic cirrhosis).

The adjusted (age, sex) hazard ratios were as follows:

· Compensated cirrhosis (vs controls): hip 4.0, wrist 1.6
· Decompensated cirrhosis (vs controls): hip 8.4, wrist 2.9
· Alcoholic cirrhosis (vs controls): hip 9.5, wrist 3.0
· Non-alcohol-related cirrhosis (vs controls): hip 3.1, wrist 1.3

"Consideration should be given to interventions in this group to reduce fracture risk," said Dr. West.

[Presentation title: Increased Risk of Hip and Wrist Fracture in Patients With Cirrhosis Compared With the General Population: A Population-Based Cohort Study. Abstract 1180]

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