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BACKGROUND: Patients with multiple sclerosis (MS) have been reported to be at higher risk of fracture than other people. We sought to test this hypothesis in a large database of hospital admissions in England. METHODS: We analysed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999-2010). Rate ratios for fractures were determined, comparing fracture rates in a cohort of all people in England admitted with MS and rates in a comparison cohort. RESULTS: Significantly elevated risk for all fractures was found in patients with MS (rate ratio (RR) = 1.99, 95% confidence interval (CI) = 1.93-2.05)). Risks were particularly high for femoral fractures (femoral neck fracture RR = 2.79 (2.65-2.93); femoral shaft fracture RR 6.69 (6.12-7.29)), and fractures of the tibia or ankle RR = 2.81 (2.66-2.96). CONCLUSIONS: Patients with MS have an increased risk of fractures. Caregivers should aim to optimize bone health in MS patients.

Original publication




Journal article


BMC Neurol

Publication Date





Adolescent, Adult, Aged, Aged, 80 and over, Databases, Factual, England, Female, Fractures, Bone, Hospitalization, Humans, Male, Medical Record Linkage, Middle Aged, Multiple Sclerosis, Risk