Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology
Background: Compared to non-indigenous populations, indigenous populations experience disproportionately greater morbidity, and a reduced life expectancy; however, conflicting data exist regarding whether a higher risk of fracture is experienced by either population. We systematically evaluate evide...
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Format: | Article |
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Elsevier
2017-06-01
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Series: | Bone Reports |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2352187217300153 |
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doaj-8ad43a4a040449d9ae93230ffb42fa32 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sharon L. Brennan-Olsen Sara Vogrin William D. Leslie Rita Kinsella Maree Toombs Gustavo Duque Sarah M. Hosking Kara L. Holloway Brianna J. Doolan Lana J. Williams Richard S. Page Julie A. Pasco Shae E. Quirk |
spellingShingle |
Sharon L. Brennan-Olsen Sara Vogrin William D. Leslie Rita Kinsella Maree Toombs Gustavo Duque Sarah M. Hosking Kara L. Holloway Brianna J. Doolan Lana J. Williams Richard S. Page Julie A. Pasco Shae E. Quirk Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology Bone Reports Fracture Incidence Indigenous peoples Risk factors Systematic review |
author_facet |
Sharon L. Brennan-Olsen Sara Vogrin William D. Leslie Rita Kinsella Maree Toombs Gustavo Duque Sarah M. Hosking Kara L. Holloway Brianna J. Doolan Lana J. Williams Richard S. Page Julie A. Pasco Shae E. Quirk |
author_sort |
Sharon L. Brennan-Olsen |
title |
Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology |
title_short |
Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology |
title_full |
Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology |
title_fullStr |
Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology |
title_full_unstemmed |
Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology |
title_sort |
fractures in indigenous compared to non-indigenous populations: a systematic review of rates and aetiology |
publisher |
Elsevier |
series |
Bone Reports |
issn |
2352-1872 |
publishDate |
2017-06-01 |
description |
Background: Compared to non-indigenous populations, indigenous populations experience disproportionately greater morbidity, and a reduced life expectancy; however, conflicting data exist regarding whether a higher risk of fracture is experienced by either population. We systematically evaluate evidence for whether differences in fracture rates at any skeletal site exist between indigenous and non-indigenous populations of any age, and to identify potential risk factors that might explain these differences.
Methods: On 31 August 2016 we conducted a comprehensive computer-aided search of peer-reviewed literature without date limits. We searched PubMed, OVID, MEDLINE, CINAHL, EMBASE, and reference lists of relevant publications. The protocol for this systematic review is registered in PROSPERO, the International Prospective Register of systematic reviews (CRD42016043215). Using the World Health Organization reference population as standard, hip fracture incidence rates were re-standardized for comparability between countries.
Results: Our search yielded 3227 articles; 283 potentially eligible articles were cross-referenced against predetermined criteria, leaving 27 articles for final inclusion. Differences in hip fracture rates appeared as continent-specific, with lower rates observed for indigenous persons in all countries except for Canada and Australia where the opposite was observed. Indigenous persons consistently had higher rates of trauma-related fractures; the highest were observed in Australia where craniofacial fracture rates were 22-times greater for indigenous compared to non-indigenous women. After adjustment for socio-demographic and clinical risk factors, approximately a three-fold greater risk of osteoporotic fracture and five-fold greater risk of craniofacial fractures was observed for indigenous compared to non-indigenous persons; diabetes, substance abuse, comorbidity, lower income, locality, and fracture history were independently associated with an increased risk of fracture.
Conclusions: The observed paucity of data and suggestion of continent-specific differences indicate an urgent need for further research regarding indigenous status and fracture epidemiology and aetiology. Our findings also have implications for communities, governments and healthcare professionals to enhance the prevention of trauma-related fractures in indigenous persons, and an increased focus on modifiable lifestyle behaviours to prevent osteoporotic fractures in all populations. |
topic |
Fracture Incidence Indigenous peoples Risk factors Systematic review |
url |
http://www.sciencedirect.com/science/article/pii/S2352187217300153 |
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doaj-8ad43a4a040449d9ae93230ffb42fa322020-11-24T23:03:45ZengElsevierBone Reports2352-18722017-06-016C14515810.1016/j.bonr.2017.04.003Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiologySharon L. Brennan-Olsen0Sara Vogrin1William D. Leslie2Rita Kinsella3Maree Toombs4Gustavo Duque5Sarah M. Hosking6Kara L. Holloway7Brianna J. Doolan8Lana J. Williams9Richard S. Page10Julie A. Pasco11Shae E. Quirk12Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, AustraliaAustralian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, AustraliaDepartment of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg R2H 2A6, CanadaAustralian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, AustraliaRural Clinical School, School of Medicine, University of Queensland, Toowoomba, 4350, QLD, AustraliaAustralian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, AustraliaDeakin University, Pigdon Road, Geelong, 3220, VIC, AustraliaDeakin University, Pigdon Road, Geelong, 3220, VIC, AustraliaDeakin University, Pigdon Road, Geelong, 3220, VIC, AustraliaDeakin University, Pigdon Road, Geelong, 3220, VIC, AustraliaDeakin University, Pigdon Road, Geelong, 3220, VIC, AustraliaDepartment of Medicine, University of Melbourne-Western Precinct, 176 Furlong Road, St Albans, 3021, VIC, AustraliaMonash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Wellington Road, Clayton, 3168, VIC, AustraliaBackground: Compared to non-indigenous populations, indigenous populations experience disproportionately greater morbidity, and a reduced life expectancy; however, conflicting data exist regarding whether a higher risk of fracture is experienced by either population. We systematically evaluate evidence for whether differences in fracture rates at any skeletal site exist between indigenous and non-indigenous populations of any age, and to identify potential risk factors that might explain these differences. Methods: On 31 August 2016 we conducted a comprehensive computer-aided search of peer-reviewed literature without date limits. We searched PubMed, OVID, MEDLINE, CINAHL, EMBASE, and reference lists of relevant publications. The protocol for this systematic review is registered in PROSPERO, the International Prospective Register of systematic reviews (CRD42016043215). Using the World Health Organization reference population as standard, hip fracture incidence rates were re-standardized for comparability between countries. Results: Our search yielded 3227 articles; 283 potentially eligible articles were cross-referenced against predetermined criteria, leaving 27 articles for final inclusion. Differences in hip fracture rates appeared as continent-specific, with lower rates observed for indigenous persons in all countries except for Canada and Australia where the opposite was observed. Indigenous persons consistently had higher rates of trauma-related fractures; the highest were observed in Australia where craniofacial fracture rates were 22-times greater for indigenous compared to non-indigenous women. After adjustment for socio-demographic and clinical risk factors, approximately a three-fold greater risk of osteoporotic fracture and five-fold greater risk of craniofacial fractures was observed for indigenous compared to non-indigenous persons; diabetes, substance abuse, comorbidity, lower income, locality, and fracture history were independently associated with an increased risk of fracture. Conclusions: The observed paucity of data and suggestion of continent-specific differences indicate an urgent need for further research regarding indigenous status and fracture epidemiology and aetiology. Our findings also have implications for communities, governments and healthcare professionals to enhance the prevention of trauma-related fractures in indigenous persons, and an increased focus on modifiable lifestyle behaviours to prevent osteoporotic fractures in all populations.http://www.sciencedirect.com/science/article/pii/S2352187217300153FractureIncidenceIndigenous peoplesRisk factorsSystematic review |