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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.

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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.

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Correspondence to J. A. Kanis.

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Johnell, O., Kanis, J.A., Odén, A. et al. Mortality after osteoporotic fractures. Osteoporos Int 15, 38–42 (2004).

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