Mortality after osteoporotic fractures
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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.
KeywordsMortality Osteoporotic fractures
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.
- 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
- 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
- 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.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.Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153Google Scholar
- 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.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.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