Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Lower fracture incidence amongst older Asian-born adults at an Australian tertiary health service (#324)

Michael Fogarty 1 , Tung Pham 2 , Jacqueline Sieffert 3 , Anna Kwok 3 , Dhiraj Samarasinghe 3 , Ritoo Choudhury 1 , Chris Preston 1 , Vivian Grill 1 3 , Hanh H Nguyen 1 3
  1. Endocrinology and Diabetes, Western Health , St Albans, Victoria, Australia
  2. Performance Unit - Health Information Services, Western Health , St Albans, Victoria, Australia
  3. Medicine, Western Health , St Albans, Victoria, Australia

Background: Western Health (WH) is a rapidly growing health service providing care to an ethnically and culturally diverse community. There is an increasing awareness of differences in fracture risk between ethnic groups1. We have examined the data in our own community.

Method: Fracture presentations at WH in adults aged >50 years between 2018-2022 were identified by ICD-10AM codes from the hospital electronic database.  Fractures of the skull, hands and feet, and presentations with ICD-10AM trauma codes were excluded. Admission, demographic and re-presentation data were extracted. Country of Birth data was grouped according to Australian Bureau of Statistics (ABS) Standard Australian Classification of Countries2. Fracture incidence was calculated based on ABS 2021 Census local population data for WH catchment3.

Results: Of 251,750 adults aged >50 years residing in the WH catchment, a majority are Australian/Oceania(47%), European(25%), and Asian(21%) born2. Between 2018-2022, 7589 patients presented to WH with 8485 fractures, including 1737 hip fractures. A majority of fractures occurred in females(69%) at a mean±SD age of 74.1±2.5years. Refracture rate was 8% over 5 years.

Of all presentations, the proportion of fractures attributed to persons born in Australia/Oceania, Europe, and Asia was 47%, 38%, and 9%, respectively. In comparison to Asian-born cases the combined incidence of hip/arm/wrist/spine and that of hip fractures alone were 3.7 and 5.4-fold higher in European-born, and 1.9 and 2.5-fold higher in Australian/Oceania-born persons than in Asian-born subjects respectively. After stratifying by age groups, Asian-born persons had a persistent pattern of lower fracture incidence across fracture types(Figure 1). 

Conclusion:  Asian-born cohorts fracture less than aged-matched Australian-Oceanic and European peers at a large Australian tertiary service. This should be acknowledged when predicting an individual’s risk of fragility fractures in our community, and the benefits and risks of treatment. Further research focusing on ethnic-specific fracture risk in Australia is warranted.

 

66b32c0520ca1-Figure+1+MF+Absract+.jpg

  1. 1. Leslie WD, Morin SN, Lix LM, et al. Fracture prediction from FRAX for Canadian ethnic groups: a registry-based cohort study. Osteoporos Int. 2021;32(1):113-122. doi:10.1007/s00198-020-05594-8
  2. 2. Australian Bureau of Statistics Standard Australian Classification of Countries (SACCC) - https://www.abs.gov.au/statistics/classifications/standard-australian-classification-countries-sacc/latest-release
  3. 3. Australian Bureau of Statistics 2021 Census Data - https://www.abs.gov.au/statistics/