Risk of Fractures, Repeated Fractures and Osteoporotic Fractures among Patients with Hemophilia in Taiwan: A 14-Year Population-Based Cohort Study

Yuan-Yi Pai, Jiaan- Der Wang, Hsin-En Ho, Yi-Jung Chou, Wen-Chao Ho, Wei-Cheng Chan, Wei-Min Chu () and Yu-Tse Tsan ()
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Yuan-Yi Pai: Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Jiaan- Der Wang: Center for Rare Disease and Hemophilia, Department of Pediatrics, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Hsin-En Ho: Department of Family Medicine, Taichung Armed Force General Hospital, Taichung 411228, Taiwan
Yi-Jung Chou: Division of Insurance Services, National Defense Medical Center, Taipei 11490, Taiwan
Wen-Chao Ho: Department of Public Health, China Medical University, Taichung 406040, Taiwan
Wei-Cheng Chan: Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Wei-Min Chu: Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Yu-Tse Tsan: Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan

IJERPH, 2022, vol. 20, issue 1, 1-10

Abstract: The world is aging, and hemophilia patients are as well. The association between patients with hemophilia (PWH) and low bone mineral density is clear. However, the incidence of fractures in patients with hemophilia is inconclusive, and no research has yet explored repeated fractures among PWH. In this study, we investigated the incidence of all-site fractures, repeated fractures and osteoporotic fractures amongst PWH. The study compared the incidence of all-site fractures, repeated fractures and osteoporotic fractures occurring in all PWH who were enrolled in Taiwan’s National Health Insurance Research Database between 1997 and 2013 with an age- and gender-matched group from the general population. Eight-hundred thirty-two PWH, along with 8320 members of the general population, were included in the final analysis. After multivariate COX regression analysis with an adjustment for confounding factors, it was found that PWH experienced a higher risk of osteoporotic fracture (HR: 1.25 with 95% CI of 1.03–2.52) but only saw a neutral effect with regards to both all-sites of fracture (HR: 1.00 with 95% CI of 0.92–1.09) and repeated fractures (HR: 1.01 with 95% CI of 0.92–1.10), when compared with the general population. This 14-year population-based cohort study showed that PWH had a higher risk of osteoporotic fracture, but that hemophilia only had a neutral effect in all-sites of fracture and repeated fractures. Screening, prevention and treatment for osteoporosis and further osteoporotic fractures among PWH, in order to improve quality of life and achieve healthy aging in this particular population, remain essential.

Keywords: hemophilia; fracture; osteoporosis; osteoporotic fracture (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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