Table 2

Rate ratios and 95% confidence intervals (CIs) for fractures in people with multiple sclerosis compared with the reference cohort
Fracture (ICD code) Observed Expected Rate Ratio (95% confidence interval) Exact P value
All fractures‡ 4414 2238.3 1.99 (1.93-2.05) <0.001*
Ribs (S22.2-S22.4 ) 161 130 1.24 (1.06-1.45) 0.007
Clavicle (S42.0) 83 52.6 1.59 (1.26-1.97) <0.001*
Humerus (S42.2-S42.4, S42.7) 415 204.2 2.05 (1.86-2.26) <0.001*
Forearm (S52) 448 493.5 0.91 (0.82-1.00) 0.042
Wrist/Hand (S62) 157 188.1 0.83 (0.71-0.98) 0.025
Pelvis/Lumbar spine (S32.0-S32.8) 293 187.7 1.57 (1.39-1.76) <0.001*
Tibia/Ankle (S82) 1393 506.1 2.81 (2.66-2.96) <0.001*
Foot (S92) 194 95.5 2.05 (1.77-2.37) <0.001*
Femur - neck of (S72.0-S72.2) 1579 574.2 2.79 (2.65-2.93) <0.001*
Femur - other (S72.3-S72.8) 543 85.8 6.69 (6.12-7.29) <0.001*
Femur - unspecified (S72.9) 88 18.5 4.91 (3.92-6.08) <0.001*
Fractures up to 1 year after first MS admission Observed Expected Rate Ratio (95% confidence interval) Exact P value
All fractures‡ 717 373.4 1.94 (1.80-2.08) <0.001*
Ribs (S22.2-S22.4) 22 20.2 1.09 (0.68-1.65) 0.779
Clavicle (S42.0) 11 7.7 1.43 (0.71-2.57) 0.319
Humerus (S42.2-S42.4, S42.7) 76 28.3 2.72 (2.14-3.41) <0.001*
Forearm (S52) 73 69.9 1.05 (0.82-1.32) 0.752
Wrist/Hand (S62) 22 28.2 0.78 (0.49-1.18) 0.278
Pelvis/Lumbar spine (S32.0-S32.8) 51 26.5 1.94 (1.44-2.56) <0.001*
Tibia/Ankle (S82) 200 80.5 2.53 (2.19-2.91) <0.001*
Foot (S92) 17 15.5 1.10 (0.64-1.77) 0.793
Femur - neck of (S72.0-S72.2) 293 88.2 3.39 (3.01-3.81) <0.001*
Femur - other (S72.3-S72.8) 58 12.3 4.88 (3.68-6.35) <0.001*
Femur - unspecified (S72.9) 18 2.7 6.91 (4.04-11.09) <0.001*
Fractures excluding those occurring in the first year after first MS admission Observed Expected Rate Ratio (95% confidence interval) Exact P value
All fractures‡ 3697 1864.9 2.00 (1.93-2.07) <0.001*
Ribs (S22.2-S22.4) 139 109.7 1.27 (1.07-1.50) 0.006
Clavicle (S42.0) 72 44.8 1.61 (1.26-2.04) <0.001*
Humerus (S42.2-S42.4, S42.7) 339 175.8 1.95 (1.74-2.17) <0.001*
Forearm (S52) 375 423.6 0.88 (0.80-0.98) 0.019
Wrist/Hand (S62) 135 159.9 0.84 (0.71-1.00) 0.053
Pelvis/Lumbar spine (S32.0-S32.8) 242 161.1 1.51 (1.32-1.71) <0.001*
Tibia/Ankle (S82) 1193 425.6 2.86 (2.70-3.03) <0.001*
Foot (S92) 177 80.1 2.24 (1.92-2.60) <0.001*
Femur - neck of (S72.0-S72.2) 1286 486 2.68 (2.54-2.84) <0.001*
Femur - other (S72.3-S72.8) 485 73.5 7.00 (6.37-7.67) <0.001*
Femur - unspecified (S72.9) 70 15.8 4.57 (3.55-5.81) <0.001*

* Significant P value after full Bonferroni correction = <0.004 (most of the high rate ratios, but none of the low rate ratios, are significant on this criterion).

† Only ICD-10 codes are shown; equivalent ICD-9 codes were also used in the analysis.

‡ ICD-10 codes: S02, S12, S22, S32, S42, S52, S62, S72, S82, S92, T08, T10, T12.

Ramagopalan et al.

Ramagopalan et al. BMC Neurology 2012 12:135   doi:10.1186/1471-2377-12-135

Open Data