Peripheral Arterial Disease Is Associated with an Increased Risk of Subsequent Hip Fracture: A Systematic Review and Meta-Analysis of Cohort Studies

Patompong Ungprasert¹, Karn Wijarnpreecha², Charat Thongprayoon² and Wisit Cheungpasitporn³, ¹Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, ²Internal medicine, Bassett medical center, cooperstown, NY, ³Medicine, University of Mississippi Medical center, Jackson, MS

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Epidemiologic methods, Fracture risk, fractures, meta-analysis and osteoporosis

Session Information

Date: Tuesday, October 23, 2018

Session Title: Osteoporosis and Metabolic Bone Disease – Basic and Clinical Science Poster

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Peripheral Arterial Disease is Associated with an Increased Risk of Subsequent Hip Fracture: A Systematic Review and Meta-Analysis of Cohort Studies

Abstract

Background/Purpose: Studies have suggested an increased risk of hip fracture among patients with peripheral arterial disease (PAD) although the results were inconsistent. This systematic review and meta-analysis was conducted with the aim to comprehensively investigate the risk of hip fracture among patients with PAD by reviewing all available studies.

Methods: A comprehensive literature review was conducted using MEDLINE and EMBASE databases through April 2018 to identify all cohort studies that compared the risk of subsequent hip fracture among patients with PAD with individuals without PAD. Effect estimates and 95% confidence intervals (CI) of the included studies were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Visualization of funnel plot was used for evaluation of publication bias.

Results: The systematic review process yielded 6 eligible cohort studies that comprised of 15,895 patients with PAD. The risk of subsequent hip fracture among patients with PAD was significantly higher than individuals without PAD with the pooled risk ratio (RR) of 1.64 (95% CI, 1.17-2.29; I² 80%). Subgroup analysis by study design revealed significant results for both prospective studies (pooled RR 1.60; 95% CI, 1.12 – 2.28; I² 0%) and retrospective studies (pooled RR 1.72; 95% CI, 1.07 – 2.77; I² 92%). The forest plot of this meta-analysis is shown as figure 1. The funnel plot (figure 2) was relatively symmetric and, thus, was not suggestive of the presence of publication bias in favor of positive studies although interpretation of the funnel plot was limited by the relatively small number of included studies.

Conclusion: This systematic review and meta-analysis demonstrated a significantly increased risk of subsequent hip fracture among patients with PAD compared with individuals without PAD.

Figure 1: Forest plot

Figure 2: Funnel plot

Disclosure: P. Ungprasert, None; K. Wijarnpreecha, None; C. Thongprayoon, None; W. Cheungpasitporn, None.

To cite this abstract in AMA style:

Ungprasert P, Wijarnpreecha K, Thongprayoon C, Cheungpasitporn W. Peripheral Arterial Disease Is Associated with an Increased Risk of Subsequent Hip Fracture: A Systematic Review and Meta-Analysis of Cohort Studies [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/peripheral-arterial-disease-is-associated-with-an-increased-risk-of-subsequent-hip-fracture-a-systematic-review-and-meta-analysis-of-cohort-studies/. Accessed March 23, 2023.

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