Cerebral palsy tied to doubled fracture risk

  • Whitney DG & al.
  • J Bone Miner Res
  • 7 Feb 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Adults (aged 16-64 years) with cerebral palsy (CP) have a higher prevalence of all-cause fracture (6.3%) than adults without CP (2.7%).
  • On multivariable analysis, the risk is double, independent of osteoporosis or cardiometabolic disease.

Why this matters

  • First epidemiology study to quantify the prevalence of fracture in adults with CP.
  • Patients and families should be advised of the higher fracture risk.

Study design

  • Cross-sectional cohort of adults with CP (n=5555) and without CP (5.5 million) identified from a large US privately insured claims database, Optum Clinformatics.
  • Funding: None disclosed.

Key results

  • Adults with CP have a higher prevalence of all-cause fracture (6.3% vs 2.7% in adults without CP; P<.01>
  • The most common fractures are in the lower extremities (3.3% vs 1.2%; P<.01 and upper extremities vs p>
  • Less common are fractures of the lumbar/pelvis region (0.5% vs 0.2%; P<.01>
  • On multivariable logistic regression:
    • Adults with CP (vs without CP) have 2.5-fold increased risk for all-cause fracture (OR, 2.5; 95% CI, 2.2-2.7).
    • After adjusting for cardiometabolic disease, the all-cause fracture risk was still double (OR, 2.2; 95% CI, 2.0-2.5).
    • After adjusting for osteoporosis, the risk remained double (OR, 2.0; 95% CI, 1.8-2.2).
  • Limitations

    • Cross-sectional design.
    • Unable to trace fracture history or cause.