Reporting of lifetime fractures: Methodological considerations and results from the Thai Cohort Study

Janneke Berecki-Gisolf*, Rod McClure, Sam Ang Seubsman, Adrian Sleigh, Jaruwan Chokhanapitak, Chaiyun Churewong, Suttanit Hounthasarn, Suwanee Khamman, Daoruang Pandee, Suttinan Pangsap, Tippawan Prapamontol, Janya Puengson, Yodyiam Sangrattanakul, Boonchai Somboonsook, Nintita Sripaiboonkij, Pathumvadee Somsamai, Duangkae Vilainerun, Wanee Wimonwattanaphan, Chris Bain, Emily BanksCathy Banwell, Bruce Caldwell, Gordon Carmichael, Tarie Dellora, Jane Dixon, Sharon Friel, David Harley, Matthew Kelly, Tord Kjellstrom, Lynette Lim, Anthony McMichael, Tanya Mark, Lyndall Strazdins, Vasoontara Yiengprugsawan

*Corresponding author for this work

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    Abstract

    Objectives: To provide estimates of fracture incidence among young adults in Thailand. Design: Cross-sectional analysis of a large national cohort. Setting: Thailand. Participants: A total of 60 569 study participants residing nationwide responded to the 2009 follow-up survey; 55% were women and median age was 34 years (range 19-92). Outcome measures: Self-reported lifetime fractures, along with age at fracture. Fracture incidence rates per person-year were then compared using lifetime fracture reports, and again selecting only fractures reported for the last year. Incidence rates were compared by age and sex. Results: 18 010 lifetime fractures were reported; 11 645(65%) by men. Lifetime fracture prevalence was 30% for men and 15% for women. Lifetime incidence per 10 000 person-years was 83; analysing only fractures from the last year yielded a corresponding incidence rate of 187. For ages 21-30, fractures per 10 000 person-years were more common among men than women (283 (95% CI 244 to 326) and 150 (130 to 173), respectively); with increasing age, rates decreased among men and increased among women (for ages 51-60, 97 (58 to 151) and 286 (189 to 417), respectively). Conclusions: Large-scale surveys provide a feasible method for establishing relative fracture incidence among informative subgroups in a population. Limiting analyses to fractures reported to have occurred recently minimises bias due to poor recall. The pattern of self-reported fracture incidence among Thais aged 20-60 was similar to that reported for Western countries: high falling rates in young men and high rising rates in older women.

    Original languageEnglish
    Article numbere001000
    JournalBMJ Open
    Volume2
    Issue number4
    DOIs
    Publication statusPublished - 1 Feb 2021

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