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Summary <p>In this global real-world study, fragility fractures of the pelvis were associated with increased risks of mortality (HR 1.63; 95% CI 1.58–1.69) and subsequent fractures (HR 2.95) in older adults with osteoporosis. Subgroup analyses further indicated markedly higher relative fracture risks among patients aged 75–79&#xa0;years (HR 4.94).</p> Purpose <p>Fragility fractures of the pelvis (FFPs) are increasingly recognized in older adults with osteoporosis; however, their long-term prognostic impact remains incompletely defined. This study evaluated the risks of mortality, hospital readmission, subsequent fractures, and immobility-related complications associated with FFP in osteoporotic older adults.</p> Methods <p>We conducted a global, retrospective cohort study using the TriNetX Research Network. Patients aged 65&#xa0;years or older with osteoporosis were categorized into an FFP group and a non-FFP control group. Propensity score matching was performed in a 1:1 ratio to balance baseline covariates. Primary outcomes included mortality, hospital readmission, and subsequent fractures, assessed at 1-, 3-, and 5-year follow-up. Secondary outcomes comprised immobility-related complications. Age-stratified subgroup analyses were conducted to evaluate differential risk patterns.</p> Results <p>After matching, 76,556 patients (38,278 per group) were included. Over 5 years of follow-up, patients with FFP exhibited significantly higher risks of mortality (HR 1.59; 95% CI 1.54–1.64), hospital readmission (HR 1.98; 95% CI 1.93–2.03), and subsequent fractures (HR 2.86; 95% CI 2.76–2.96) compared with controls. FFP was also associated with increased risks of immobility-related complications, including infections, thromboembolic events, and pressure ulcers. Analyses stratifying patients aged 65–79&#xa0;years into three subgroups yielded consistent and highly elevated relative risks across all strata, whereas absolute event burdens were greatest among those aged 80&#xa0;years or older.</p> Conclusions <p>FFPs are associated with substantially increased long-term mortality, morbidity, and healthcare utilization in older adults with osteoporosis. These findings establish FFP as a high-risk condition warranting proactive, age-tailored secondary prevention, functional rehabilitation, and long-term care strategies.</p>

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Fragility fractures of the pelvis and long-term outcomes among older adults with osteoporosis: a real-world cohort study

  • 期刊论文

  • 发表日期：

    2026年5月9日

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  • Po-Chun Wang,
  • Hung Su,
  • Lien-Chen Wu,
  • Yi-Jie Kuo,
  • Yu-Pin Chen

摘要

Summary

In this global real-world study, fragility fractures of the pelvis were associated with increased risks of mortality (HR 1.63; 95% CI 1.58–1.69) and subsequent fractures (HR 2.95) in older adults with osteoporosis. Subgroup analyses further indicated markedly higher relative fracture risks among patients aged 75–79 years (HR 4.94).

Purpose

Fragility fractures of the pelvis (FFPs) are increasingly recognized in older adults with osteoporosis; however, their long-term prognostic impact remains incompletely defined. This study evaluated the risks of mortality, hospital readmission, subsequent fractures, and immobility-related complications associated with FFP in osteoporotic older adults.

Methods

We conducted a global, retrospective cohort study using the TriNetX Research Network. Patients aged 65 years or older with osteoporosis were categorized into an FFP group and a non-FFP control group. Propensity score matching was performed in a 1:1 ratio to balance baseline covariates. Primary outcomes included mortality, hospital readmission, and subsequent fractures, assessed at 1-, 3-, and 5-year follow-up. Secondary outcomes comprised immobility-related complications. Age-stratified subgroup analyses were conducted to evaluate differential risk patterns.

Results

After matching, 76,556 patients (38,278 per group) were included. Over 5 years of follow-up, patients with FFP exhibited significantly higher risks of mortality (HR 1.59; 95% CI 1.54–1.64), hospital readmission (HR 1.98; 95% CI 1.93–2.03), and subsequent fractures (HR 2.86; 95% CI 2.76–2.96) compared with controls. FFP was also associated with increased risks of immobility-related complications, including infections, thromboembolic events, and pressure ulcers. Analyses stratifying patients aged 65–79 years into three subgroups yielded consistent and highly elevated relative risks across all strata, whereas absolute event burdens were greatest among those aged 80 years or older.

Conclusions

FFPs are associated with substantially increased long-term mortality, morbidity, and healthcare utilization in older adults with osteoporosis. These findings establish FFP as a high-risk condition warranting proactive, age-tailored secondary prevention, functional rehabilitation, and long-term care strategies.