Advertisement

Osteoporosis International

, Volume 15, Issue 1, pp 38–42 | Cite as

Mortality after osteoporotic fractures

  • O. Johnell
  • J. A. Kanis
  • A. Odén
  • I. Sernbo
  • I. Redlund-Johnell
  • C. Petterson
  • C. De Laet
  • B. Jönsson
Original Article

Abstract

The aim of this study was to examine the pattern of mortality following osteoporotic fractures at the spine, shoulder, hip, and forearm. We studied 2,847 patients with fractures at these sites identified from the radiology department in Malmö, Sweden. Poisson regression was used to compute mortality immediately after the fracture and with time. Mortality immediately after fracture was significantly higher in fracture cases than in the general population except for forearm fractures in both men and women. Mortality was higher in men than in women, but not different when adjusted for sex-specific population risks. For spine, shoulder, and hip fracture, mortality fell after the 1st year, an effect that was most marked for patients with spine fractures. The decrease in mortality risk with time was significant for hip, vertebral, and shoulder fracture. We conclude that the risk of death is increased in patients with osteoporotic fractures and that the highest risk is found immediately after the fracture event. The decreasing mortality with time after fracture may be due in part to a decrease in deaths causally related to the fracture. The extent to which early intervention for osteoporosis might avoid some of these deaths is unknown.

Keywords

Mortality Osteoporotic fractures 

Notes

Acknowledgements

We are grateful to the Alliance for Better Bone Health, G-E Lunar Hologić, the International Osteoporosis Foundation, the International Society for Clinical Densitometry, Lilly, Novartis, Pfizer, Roche and Wyeth for unrestricted grants to support these studies. We are grateful to the EPC (National Board of Health and Welfare), Sweden, for access to the death register for Sweden.

References

  1. 1.
    Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ III (1993) Population-based study of survival after osteoporotic fractures. AM J Epidemiol 137:1001–1005PubMedGoogle Scholar
  2. 2.
    Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882PubMedGoogle Scholar
  3. 3.
    Johnell O, Haglund B (1999) Co-morbidity and mortality in hip fracture patients: a population-based study. J Bone Miner Res 14[Suppl 1]:S160Google Scholar
  4. 4.
    Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561CrossRefPubMedGoogle Scholar
  5. 5.
    Ismail AA, O’Neill TW, Cooper C et al on behalf of the EPOS Study Group (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8:291–297CrossRefPubMedGoogle Scholar
  6. 6.
    Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1992) Race and sex differences in mortality following fracture in hip. Am J Public Health 82:1147–1150PubMedGoogle Scholar
  7. 7.
    Magaziner J, Simonsick EM, Kashner M, Hebel JR, Kenzora JE (1989) Survival experience of aged hip fracture patients. Am J Public Health 73:274–278Google Scholar
  8. 8.
    Todd C, Freeman C, Camilleri-Ferrante C, Palmer CR, Hyder A, Laxton CE, Parker M, Payne BV, Rushton N (1995) Differences in mortality after fracture of the hip. BMJ 310:904–908PubMedGoogle Scholar
  9. 9.
    Todd C, Freeman C, Camilleri-Ferrant C, Laxton C, Murrel P, Palmer C, Parker M, Payne B, Rushton N (1999) Anglian audit of hip fracture II. Institute of Public Health, University of Cambridge, CambridgeGoogle Scholar
  10. 10.
    Weiss NS, Liff JM, Ure CL, Ballard JH, Abbott GH, Daling JR (1983) Mortality in women following hip fracture. J Chron Dis 12:879–882Google Scholar
  11. 11.
    Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153Google Scholar
  12. 12.
    Melton LJ III, Therneau TM, Larson DR (1998) Long-term trends in hip fracture prevalence: the influence of hip fracture incidence and survival. Osteoporos Int 8:68–74CrossRefPubMedGoogle Scholar
  13. 13.
    Forsén L, Søgaard AJ, Meyer HE, Edna T-H, Kopjar B (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10:73–78CrossRefPubMedGoogle Scholar
  14. 14.
    Browner WS, Pressman AR, Nevitt MC, Cummings SR, for the Study of Osteoporotic Fractures Research Group (1996) Mortality following fractures in older women. Arch Intern Med 156:1521–1525PubMedGoogle Scholar
  15. 15.
    Browner WS, Seeley DG, Vogt TM, Cummings SR (1991) Non-traumatic mortality in elderly women with low bone mineral density. Lancet 338:355–358PubMedGoogle Scholar
  16. 16.
    Johansson C, Black D, Johnell O, Odén A, Mellström D (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63:190–196CrossRefPubMedGoogle Scholar
  17. 17.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby A (2003) The components of excess mortality after hip fracture. Bone 32:468–473CrossRefPubMedGoogle Scholar
  18. 18.
    Kanis JA, Johnell O, Odén A, Sernbo I, Redlund-Johnell I, Dawson A, De Laet C, Jönsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674CrossRefPubMedGoogle Scholar
  19. 19.
    Jonsson B, Gardsell P, Johnell O, Redlund-Johnell I, Sernbo I (1994) Remembering fractures: fracture registration and proband recall in Southern Sweden. J Epidemiol Comm Health 48:489–490Google Scholar
  20. 20.
    Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O (2003) Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10 year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int 14:61–68PubMedGoogle Scholar
  21. 21.
    Ensrud KE, Thompson DE, Cauley JE et al (2000) Prevalent vertebral deformities predict mortality and hospitalisation in older women with low bone mass. J Amer Geriatr Soc 48:241–249Google Scholar
  22. 22.
    Ismail AA, O’Neill TW, Cooper C et al (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8:821–827CrossRefGoogle Scholar
  23. 23.
    Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women. The study of osteoporotic fractures. Arch Intern Med 159:1215–1220PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • O. Johnell
    • 1
  • J. A. Kanis
    • 2
  • A. Odén
    • 3
  • I. Sernbo
    • 1
  • I. Redlund-Johnell
    • 1
  • C. Petterson
    • 1
  • C. De Laet
    • 4
  • B. Jönsson
    • 5
  1. 1.Department of OrthopaedicsMalmö University HospitalMalmöSweden
  2. 2.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  3. 3.Consulting StatisticianGothenburgSweden
  4. 4.Institute for Public HealthErasmus University Medical CenterRotterdamThe Netherlands
  5. 5.Department of EconomicsStockholm School of EconomicsStockholmSweden

Personalised recommendations