TY - JOUR
T1 - Brief Report
T2 - Are Serious Falls Associated with Subsequent Fragility Fractures among Veterans Living with HIV?
AU - Womack, Julie A.
AU - Murphy, Terrence E.
AU - Ramsey, Christine
AU - Bathulapalli, Harini
AU - Leo-Summers, Linda
AU - Smith, Alexandria C.
AU - Bates, Jonathan
AU - Jarad, Samah
AU - Gill, Thomas M.
AU - Hsieh, Evelyn
AU - Rodriguez-Barradas, Maria C.
AU - Tien, Phyllis C.
AU - Yin, Michael T.
AU - Brandt, Cynthia
AU - Justice, Amy C.
N1 - Funding Information:
Supported by the National Institute of Nursing Research (Grant number K01 NR013437), the National Center for Research Resources and National Center for Advancing Translational Sciences (Grant number UL1 RR024139), the National Institute on Aging (Grant numbers K07 AG043587 and P30 AG21342), and the National Institute on Alcohol Abuse and Alcoholism (Grant numbers U10 AA013566, U24 AA022001, U01 AA020790, and U01 AA026224).
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background:The extensive research on falls and fragility fractures among persons living with HIV (PWH) has not explored the association between serious falls and subsequent fragility fracture. We explored this association.Setting:Veterans Aging Cohort Study.Methods:This analysis included 304,951 6-month person- intervals over a 15-year period (2001-2015) contributed by 26,373 PWH who were 50+ years of age (mean age 55 years) and taking antiretroviral therapy (ART). Serious falls (those falls significant enough to result in a visit to a health care provider) were identified by the external cause of injury codes and a machine learning algorithm applied to radiology reports. Fragility fractures were identified using ICD9 codes and included hip fracture, vertebral fractures, and upper arm fracture and were modeled with multivariable logistic regression with generalized estimating equations.Results:After adjustment, serious falls in the previous year were associated with increased risk of fragility fracture [odds ratio (OR) 2.10; 95% confidence interval (CI): 1.83 to 2.41]. The use of integrase inhibitors was the only ART risk factor (OR 1.17; 95% CI: 1.03 to 1.33). Other risk factors included the diagnosis of alcohol use disorder (OR 1.49; 95% CI: 1.31 to 1.70) and having a prescription for an opioid in the previous 6 months (OR 1.40; 95% CI: 1.27 to 1.53).Conclusions:Serious falls within the past year are strongly associated with fragility fractures among PWH on ART - largely a middle-aged population - much as they are among older adults in the general population.
AB - Background:The extensive research on falls and fragility fractures among persons living with HIV (PWH) has not explored the association between serious falls and subsequent fragility fracture. We explored this association.Setting:Veterans Aging Cohort Study.Methods:This analysis included 304,951 6-month person- intervals over a 15-year period (2001-2015) contributed by 26,373 PWH who were 50+ years of age (mean age 55 years) and taking antiretroviral therapy (ART). Serious falls (those falls significant enough to result in a visit to a health care provider) were identified by the external cause of injury codes and a machine learning algorithm applied to radiology reports. Fragility fractures were identified using ICD9 codes and included hip fracture, vertebral fractures, and upper arm fracture and were modeled with multivariable logistic regression with generalized estimating equations.Results:After adjustment, serious falls in the previous year were associated with increased risk of fragility fracture [odds ratio (OR) 2.10; 95% confidence interval (CI): 1.83 to 2.41]. The use of integrase inhibitors was the only ART risk factor (OR 1.17; 95% CI: 1.03 to 1.33). Other risk factors included the diagnosis of alcohol use disorder (OR 1.49; 95% CI: 1.31 to 1.70) and having a prescription for an opioid in the previous 6 months (OR 1.40; 95% CI: 1.27 to 1.53).Conclusions:Serious falls within the past year are strongly associated with fragility fractures among PWH on ART - largely a middle-aged population - much as they are among older adults in the general population.
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U2 - 10.1097/QAI.0000000000002752
DO - 10.1097/QAI.0000000000002752
M3 - Article
C2 - 34506360
AN - SCOPUS:85123036700
SN - 1525-4135
VL - 88
SP - 192
EP - 196
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 2
ER -