Evidence mapPaperPMID 31471664Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020

Socio-economic inequalities in fragility fracture outcomes: a systematic review and meta-analysis of prognostic observational studies.

G Valentin, S E Pedersen, R Christensen, K Friis, C P Nielsen, A Bhimjiyani, C L Gregson, B L Langdahl

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Pooled it
  3. Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Pooled it
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  18. Post-fracture care programs for prevention of subsequent fragility fractures: a literature assessment of current trends.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Review
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  20. Social deprivation predicts adverse health outcomes after hospital admission with hip fracture in England.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

G ValentinDepartment of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Denmark. Gitte.valentin@rm.dk.ORCID http://orcid.org/0000-0002-0668-6862
S E PedersenDepartment of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Denmark.
R ChristensenMusculoskeletal Statistics Unit, The Parker Institute, Bispeberg and Frederiksberg Hospital & Research Unit of Rhematology, Copenhagen, Denmark & Department of Clinical Researh University of Southern Denmark, Odense University Hospital, Odense, Denmark.
K FriisDepartment of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Denmark.
C P NielsenDepartment of Public Health and Health Services Research, DEFACTUM, Central Denmark Region, Denmark.
A BhimjiyaniMusculoskeletal Research Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Bristol, BS10 5NB, UK.
C L GregsonMusculoskeletal Research Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Bristol, BS10 5NB, UK.
B L LangdahlDepartment of Endocrinology (MEA), Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Central Denmark Region · DKSouthmead Hospital · GBAarhus University Hospital · DKUniversity of Southern Denmark · DK

Funding

DEFACTUM ?Oak Foundation OCAY-13-309Sundhedsvidenskabelige Fakultet, Aarhus Universitet ?The Danish Osteoporosis Society ?UK Royal Osteoporosis Society ?Versus Arthritis 20000
6 · The paper itself

Abstract

Individuals with low socio-economic status (SES) have a higher risk of dying following hip fracture compared with individuals with high SES. Evidence on social inequalities in non-hip fractures is lacking as well as evidence on the impact of SES on health-related quality of life post fracture.

introductionFragility fractures, especially of the hip, cause substantial excess mortality and impairment in health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate the association between socio-economic status (SES) and post-fracture mortality and HRQoL.

methodsPubMed, EMBASE and CINAHL databases were searched from inception to the last week of November 2018 for studies reporting an association between SES and post-fracture mortality and/or HRQoL among people aged ≥ 50 years. Risk ratios (RRs) were meta-analyzed using a standard inverse-variance-weighted random effects model. Studies using individual-level and area-based SES measures were analyzed separately.

resultsA total of 24 studies from 15 different countries and involving more than one million patients with hip fractures were included. The overall risk of mortality within 1-year post-hip fracture in individuals with low SES was 24% higher than in individuals with high SES (RR 1.24, 95% CI 1.19 to 1.29) for individual-level SES measures, and 14% (RR 1.14, 95% CI 1.09 to 1.19) for area-based SES measures. The quality of the evidence for the outcome mortality was moderate. Using individual SES measures, we estimated the excess HRQoL loss to be 5% (95% CI - 1 to 10%) among hip fracture patients with low SES compared with high SES.

conclusionsWe found a consistently increased risk of post-hip fracture mortality with low SES across SES measures and across countries with different political structures and different health and social care infrastructures. The impact of SES on post-fracture HRQoL remains uncertain due to sparse and low-quality evidence.

Indexed as

FrailtyHealth Status DisparitiesHip FracturesQuality of LifeAgedFemaleHumansPrognosisSocioeconomic FactorsFracturesHealth-related quality of lifeInequalityMortalitySocio-economic status

Identifiers

PMID31471664
OpenAlexW2970593596

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.