Association between timing of surgery and refracture after initial osteoporotic fractures
Abstract Osteoporotic refracture may result from multiple risk factors. However, few studies have explored the association between the interval from the initial fracture to surgery (i.e., the timing of surgery) and osteoporotic refracture. This study aims to investigate the significant risk factors...
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Nature Portfolio
2025-06-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-04672-3 |
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| author | Zhujie Xu Peng Wang Yang Qiu Yi Liu |
| author_facet | Zhujie Xu Peng Wang Yang Qiu Yi Liu |
| author_sort | Zhujie Xu |
| collection | DOAJ |
| description | Abstract Osteoporotic refracture may result from multiple risk factors. However, few studies have explored the association between the interval from the initial fracture to surgery (i.e., the timing of surgery) and osteoporotic refracture. This study aims to investigate the significant risk factors of osteoporotic refracture and to provide more reliable interventions for its prevention. A total of 502 hospitalized patients with osteoporotic fractures from January 2017 to December 2022 at Nanjing Medical University Affiliated Wuxi People’s Hospital were retrospectively analyzed. This included 52 cases in the refracture group and 450 cases in the non-refracture group. Univariate analysis revealed significant differences between the refracture and non-refracture groups. These differences included age, height, body mass index (BMI), bone mineral density (BMD), hemoglobin concentration, total serum protein concentration, pain level, and the interval from fracture to surgery. Further binary logistic regression and Cox proportional hazard regression both indicated that the interval from fracture to surgery, pain level, and age were independent risk factors for refracture. According to the results of receiver operating characteristic (ROC), the prediction accuracy of interval time was high, with area under ROC (AUC) of 0.782, sensitivity of 63.5%, specificity of 84.4%, and threshold value of 10.5. Our study suggests that a longer interval from initial fracture to surgery is associated with an increased risk of refracture, with 10.5 days being the optimal threshold based on ROC analysis. |
| format | Article |
| id | doaj-art-b124c1eafdbd4dde93d0ef61e2c698bc |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-b124c1eafdbd4dde93d0ef61e2c698bc2025-08-20T02:05:38ZengNature PortfolioScientific Reports2045-23222025-06-0115111010.1038/s41598-025-04672-3Association between timing of surgery and refracture after initial osteoporotic fracturesZhujie Xu0Peng Wang1Yang Qiu2Yi Liu3Department of Orthopedics, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical UniversityDepartment of Orthopedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou Central Hospital Affiliated to Medical School of Southeast University, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese MedicineThe First Clinical Medical Colledge, Nanjing Medical UniversityDepartment of Orthopedics, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical UniversityAbstract Osteoporotic refracture may result from multiple risk factors. However, few studies have explored the association between the interval from the initial fracture to surgery (i.e., the timing of surgery) and osteoporotic refracture. This study aims to investigate the significant risk factors of osteoporotic refracture and to provide more reliable interventions for its prevention. A total of 502 hospitalized patients with osteoporotic fractures from January 2017 to December 2022 at Nanjing Medical University Affiliated Wuxi People’s Hospital were retrospectively analyzed. This included 52 cases in the refracture group and 450 cases in the non-refracture group. Univariate analysis revealed significant differences between the refracture and non-refracture groups. These differences included age, height, body mass index (BMI), bone mineral density (BMD), hemoglobin concentration, total serum protein concentration, pain level, and the interval from fracture to surgery. Further binary logistic regression and Cox proportional hazard regression both indicated that the interval from fracture to surgery, pain level, and age were independent risk factors for refracture. According to the results of receiver operating characteristic (ROC), the prediction accuracy of interval time was high, with area under ROC (AUC) of 0.782, sensitivity of 63.5%, specificity of 84.4%, and threshold value of 10.5. Our study suggests that a longer interval from initial fracture to surgery is associated with an increased risk of refracture, with 10.5 days being the optimal threshold based on ROC analysis.https://doi.org/10.1038/s41598-025-04672-3OsteoporosisRefractureIntervalTiming of surgeryRisk factors |
| spellingShingle | Zhujie Xu Peng Wang Yang Qiu Yi Liu Association between timing of surgery and refracture after initial osteoporotic fractures Scientific Reports Osteoporosis Refracture Interval Timing of surgery Risk factors |
| title | Association between timing of surgery and refracture after initial osteoporotic fractures |
| title_full | Association between timing of surgery and refracture after initial osteoporotic fractures |
| title_fullStr | Association between timing of surgery and refracture after initial osteoporotic fractures |
| title_full_unstemmed | Association between timing of surgery and refracture after initial osteoporotic fractures |
| title_short | Association between timing of surgery and refracture after initial osteoporotic fractures |
| title_sort | association between timing of surgery and refracture after initial osteoporotic fractures |
| topic | Osteoporosis Refracture Interval Timing of surgery Risk factors |
| url | https://doi.org/10.1038/s41598-025-04672-3 |
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