{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:36:46Z","timestamp":1793317006526,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":1152,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T00:00:00Z","timestamp":1662768000000},"content-version":"vor","delay-in-days":648,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Research foundation of VieCuri Medical Center","award":["n.a."],"award-info":[{"award-number":["n.a."]}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Fracture liaison services (FLS) are considered to be the most effective organizational approach for secondary fracture prevention. In this study, we evaluated whether FLS care was associated with reduced subsequent fracture and mortality risk over 3\u2009years of follow-up. In total, 8682 consecutive patients aged 50\u201390\u2009years with a recent fracture were included. Before FLS introduction, regular fracture treatment procedures were followed (pre-FLS). After FLS introduction, patients were invited to the FLS and FLS attenders were assessed for osteoporosis, prevalent vertebral fractures, metabolic bone disorders, medication use, and fall risk, and treatment for fracture prevention was initiated according to Dutch guidelines. All fractures were radiographically confirmed and categorized into major\/hip (pelvis, proximal humerus or tibia, vertebral, multiple rib, distal femur) and non-major\/non-hip (all other fractures). Mortality risk was examined using age and sex adjusted Cox proportional hazard models. For subsequent fracture risk, Cox proportional hazard models were adjusted for age, sex, and competing mortality risk (subdistribution hazard [SHR] approach). The pre-FLS group consisted of 2530 patients (72% women), of whom 1188 (46.9%) had major\/hip index fractures, the post-FLS group consisted of 6152 patients (69% women), of whom 2973 (48.3%) had major\/hip index fractures. In patients with a non-major\/non-hip fracture there was no difference in subsequent non-major\/non-hip fracture risk or mortality between pre-FLS and post-FLS. In patients with a major\/hip index fracture, mortality risk was lower post-FLS (hazard ratio [HR] 0.84; 95% confidence interval [CI], 0.73\u20130.96) and subsequent major\/hip fracture risk was lower in the first 360\u2009days after index fracture post-FLS compared to pre-FLS (SHR 0.67; 95% CI, 0.52\u20130.87). In conclusion, FLS care was associated with a lower mortality risk in the first 3\u2009years and a lower subsequent major\/hip fracture risk in the first year in patients with a major\/hip index fracture but not in patients with a non-major\/non-hip fracture. \u00a9 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4674","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T06:38:04Z","timestamp":1660199884000},"page":"2025-2032","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Decreased Mortality and Subsequent Fracture Risk in Patients With a Major and Hip Fracture After the Introduction of a Fracture Liaison Service: A 3-Year Follow-Up Survey"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6925-4397","authenticated-orcid":false,"given":"Lisanne","family":"Vranken","sequence":"first","affiliation":[{"name":"Department of Internal Medicine NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+ Maastricht The Netherlands"},{"name":"Department of Internal Medicine VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-4971","authenticated-orcid":false,"given":"Irma J.A.","family":"de Bruin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+ Maastricht The Netherlands"},{"name":"Department of Internal Medicine VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4503-6408","authenticated-orcid":false,"given":"Annemariek H.M.","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Toxicology NUTRIM School of Nutrition and Translational Research in Metabolism, CARIM School for Cardiovascular Disease, Maastricht UMC+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7547-9146","authenticated-orcid":false,"given":"Piet P.M.","family":"Geusens","sequence":"additional","affiliation":[{"name":"Department of Medicine and Life Sciences Hasselt University Hasselt Belgium"},{"name":"Department of Internal Medicine Subdivision Rheumatology, Maastricht UMC+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-7471","authenticated-orcid":false,"given":"John A.","family":"Eisman","sequence":"additional","affiliation":[{"name":"School of Medicine Sydney University of Notre Dame Australia Sydney New South Wales Australia"},{"name":"Clinical School, St Vincent's Faculty of Medicine, UNSW Sydney Kensington New South Wales Australia"},{"name":"Osteoporosis and Bone Biology Division Garvan Institute of Medical Research Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5278-4527","authenticated-orcid":false,"given":"Jacqueline R.","family":"Center","sequence":"additional","affiliation":[{"name":"Clinical School, St Vincent's Faculty of Medicine, UNSW Sydney Kensington New South Wales Australia"},{"name":"Osteoporosis and Bone Biology Division Garvan Institute of Medical Research Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3239-2753","authenticated-orcid":false,"given":"Robert Y.","family":"van der Velde","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+ Maastricht The Netherlands"},{"name":"Department of Internal Medicine VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0195-5840","authenticated-orcid":false,"given":"Heinrich M.J.","family":"Janzing","sequence":"additional","affiliation":[{"name":"Department of Surgery VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8811-4464","authenticated-orcid":false,"given":"Sjoerd","family":"Kaarsemaker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-2232","authenticated-orcid":false,"given":"Joop P.","family":"van den Bergh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+ Maastricht The Netherlands"},{"name":"Department of Internal Medicine VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7662-3990","authenticated-orcid":false,"given":"Caroline E.","family":"Wyers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+ Maastricht The Netherlands"},{"name":"Department of Internal Medicine VieCuri Medical Center Venlo The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0001","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/jbmr.2393","article-title":"Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the Dubbo Osteoporosis Epidemiology Study","volume":"30","author":"Bliuc","year":"2015","journal-title":"J Bone Miner Res"},{"issue":"9","key":"2024012714050122200_jbmr4674-bib-0002","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/jbmr.3118","article-title":"Population-wide impact of non-hip non-vertebral fractures on mortality","volume":"32","author":"Tran","year":"2017","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0003","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1359\/jbmr.2000.15.4.721","article-title":"Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis","volume":"15","author":"Klotzbuecher","year":"2010","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0004","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.maturitas.2010.09.002","article-title":"Clinical fractures cluster in time after initial fracture","volume":"67","author":"Laurs - van Geel","year":"2010","journal-title":"Maturitas"},{"issue":"1","key":"2024012714050122200_jbmr4674-bib-0005","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s11657-020-0706-y","article-title":"Fragility fractures in Europe: burden, management and opportunities","volume":"15","author":"Borgstrom","year":"2020","journal-title":"Arch Osteoporos"},{"issue":"2","key":"2024012714050122200_jbmr4674-bib-0006","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s00198-012-2090-y","article-title":"Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis","volume":"24","author":"Ganda","year":"2012","journal-title":"Osteoporos Int"},{"issue":"5","key":"2024012714050122200_jbmr4674-bib-0007","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1136\/annrheumdis-2016-210289","article-title":"EULAR\/EFORT recommendations for management of patients older than 50\u2009years with a fragility fracture and prevention of subsequent fractures","volume":"76","author":"Lems","year":"2017","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"2024012714050122200_jbmr4674-bib-0008","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1002\/jbmr.1698","article-title":"Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention","volume":"27","author":"Eisman","year":"2012","journal-title":"J Bone Miner Res"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0009","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/BOR.0000000000000401","article-title":"Fracture liaison services","volume":"29","author":"Briot","year":"2017","journal-title":"Curr Opin Rheumatol"},{"issue":"7","key":"2024012714050122200_jbmr4674-bib-0010","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1759720X17706464","article-title":"Fracture liaison services: do they reduce fracture rates?","volume":"9","author":"de Bruin","year":"2017","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"2024012714050122200_jbmr4674-bib-0011","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.bone.2018.03.018","article-title":"Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis","volume":"111","author":"Wu","year":"2018","journal-title":"Bone"},{"issue":"8","key":"2024012714050122200_jbmr4674-bib-0012","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1007\/s00198-021-05911-9","article-title":"The impact of fracture liaison services on subsequent fractures and mortality: a systematic literature review and meta-analysis","volume":"32","author":"Li","year":"2021","journal-title":"Osteoporos Int"},{"key":"2024012714050122200_jbmr4674-bib-0013","volume-title":"Guideline Osteoporosis and Fracture prevention","author":"Working group CBO","year":"2011"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0014","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/BOR.0000000000000074","article-title":"Secondary osteoporosis and metabolic bone disease in patients 50\u2009years and older with osteoporosis or with a recent clinical fracture: a clinical perspective","volume":"26","author":"Bours","year":"2014","journal-title":"Curr Opin Rheumatol"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0015","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1001\/jama.297.4.387","article-title":"Risk of subsequent fracture after low-trauma fracture in men and women","volume":"297","author":"Center","year":"2007","journal-title":"JAMA"},{"issue":"446","key":"2024012714050122200_jbmr4674-bib-0016","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"issue":"11","key":"2024012714050122200_jbmr4674-bib-0017","doi-asserted-by":"crossref","first-page":"2670","DOI":"10.1093\/ndt\/gft355","article-title":"When do we need competing risks methods for survival analysis in nephrology?","volume":"28","author":"Noordzij","year":"2013","journal-title":"Nephrol Dial Transplant"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0018","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00198-007-0543-5","article-title":"FRAX and the assessment of fracture probability in men and women from the UK","volume":"19","author":"Kanis","year":"2008","journal-title":"Osteoporos Int"},{"issue":"3","key":"2024012714050122200_jbmr4674-bib-0019","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1002\/pds.1357","article-title":"Immortal time bias in observational studies of drug effects","volume":"16","author":"Suissa","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"7","key":"2024012714050122200_jbmr4674-bib-0020","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1002\/jbmr.3990","article-title":"Association between recurrent fracture risk and implementation of fracture liaison services in four Swedish hospitals: a cohort study","volume":"35","author":"Axelsson","year":"2020","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2024012714050122200_jbmr4674-bib-0021","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1093\/ageing\/afv204","article-title":"Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: population-based longitudinal study","volume":"45","author":"Hawley","year":"2016","journal-title":"Age Ageing"},{"issue":"3","key":"2024012714050122200_jbmr4674-bib-0022","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s00198-015-3443-0","article-title":"Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate","volume":"27","author":"Nakayama","year":"2016","journal-title":"Osteoporos Int"},{"issue":"6","key":"2024012714050122200_jbmr4674-bib-0023","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/ajr.12355","article-title":"Prevention of osteoporotic refractures in regional Australia","volume":"25","author":"Davidson","year":"2017","journal-title":"Aust J Rural Health"},{"issue":"4","key":"2024012714050122200_jbmr4674-bib-0024","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.2106\/JBJS.L.00223","article-title":"Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality","volume":"96","author":"Huntjens","year":"2014","journal-title":"J Bone Joint Surg Am"},{"issue":"8","key":"2024012714050122200_jbmr4674-bib-0025","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s00198-020-05410-3","article-title":"Osteoporosis care after distal radius fracture reduces subsequent hip or spine fractures: a 4-year longitudinal study","volume":"31","author":"Shin","year":"2020","journal-title":"Osteoporos Int"},{"issue":"6","key":"2024012714050122200_jbmr4674-bib-0026","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1007\/s00198-015-3084-3","article-title":"Long-term persistence with anti-osteoporosis drugs after fracture","volume":"26","author":"Klop","year":"2015","journal-title":"Osteoporosis Int"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbmr.4674","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jbmr.4674","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/37\/10\/2025\/55454515\/jbmr4674.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/37\/10\/2025\/55454515\/jbmr4674.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:45:53Z","timestamp":1710341153000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/37\/10\/2025-2032\/7512342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,1]]},"references-count":26,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,8,10]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/jbmr.4674","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12,1]]},"published":{"date-parts":[[2020,12,1]]},"assertion":[{"value":"2022-04-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}