Prevalence of fractures among Thais with Thalassaemia syndromes

Abstract

Introduction: The association of fractures with thalassaemia syndromes is well established. The aim of this study was to determine the prevalence and risk factors for fracture in Thai people with thalassaemia syndromes. Methods: A retrospective study and a patient interview were conducted in 201 Thai thalassaemia patients who attended the Division of Haematology, Department of Medicine Siriraj Hospital, Thailand. The patient interview questionnaire included sections on demographics, medical, orthopaedic and surgical history, usage of tobacco and alcohol, as well as questions that pertained to fracture. The risk factors for fracture were determined by odds ratio. Results: The prevalence of fracture in Thai people with thalassaemia syndromes was 35.3 percent. Fracture occurred more of ten in beta thalassaemia patients (44.1 percent) than in alpha thalassaemia patients (16.9 percent). Upper extremity was the most common site of fracture, while falls and motor vehicle accidents were the most common causes of fracture, and cast/splint was the most common choice of treatment. 28 percent of the patients sustained multiple fractures. Among alpha thalassaemia patients, adults sustained fractures more frequently than children and adolescents. In contrast, beta thalassaemia children had a greater rate of fracture than the adults and adolescents. The risk factors for fracture in thalassaemia patients included male gender, beta thalassaemia, splenectomy, transfusion and a low body mass index. Conclusion: A high prevalence of fracture is observed among Thais with thalassaemia. The aetiology was found to be multifactorial.