Abstract
Several osteoporotic fractures such as hip fractures have a very high morbidity and mortality, and there are similar new findings for vertebral fractures. There have been several definitions of an osteoporotic fracture, and recently updated definitions have specified fractures occurring at a site associated with low BMD and which increase in incidence after the age of 50 years. Other definitions are based on clinical diagnosis. Lifetime risk of any osteoporotic fracture is very high and lies within the range of 40–50% in women and 13–22% for men. Measuring the true burden of osteoporotic fractures involves multiplying the morbidity of hip fractures according to age group: for women aged 50–54 years, the disability caused by osteoporotic fractures is 6.07 times that accounted for by hip fracture alone, and for women aged 80–84 years, the incidence of hip fractures should be multiplied by 1.55; for men aged 50–54 years, the incidence of hip fractures should be multiplied by 4.48, and for those aged 80–84 years by 1.50.
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References
Consensus Development Conference (1991) Prophylaxis and treatment of osteoporosis. Am J Med 90:107–110
World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series. WHO, Geneva
Gärdsell P, Johnell O (1993) Bone mass: a marker of biologic age? Clin Orthop 287:90–93
Johansson C, Black D, Johnell O, Odén A, Mellström D (1998) Bone mineral density is a predictor of survival. Calcif Tissue Int 63:190–196
Browner WS, Seeley D, Vogt TM, Cummings SR (1991) Non-trauma mortality in elderly women with low bone mineral density. Study of Osteoporotic Fractures Research Group. Lancet 338:355–358
Kanis JA, Odén A, Johnell O Jönsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427
Kanis JA, Johnell O, Odén A, Borgström F, Zethraeus N, De Laet C, Jönsson B (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int15(1):20–26
Melton LJ III, Chriscilles EA, Cooper C, Lane AW, Riggs BL (1992) Perspective: how many women have osteoporosis? J Bone Miner Res 7:1005–1010
van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522
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 11:669–674
Doherty DA, Sanders KM, Kotowicz MA, Prince RL (2001) Lifetime and five-year age-specific risks of first and subsequent osteoporotic fractures in postmenopausal women. Osteoporos Int 12:16–23
Sernbo I, Johnell O (1993) Consequences of a hip fracture: a prospective study over 1 year. Osteoporos Int 3:148–153
Kanis JA, Odén A, Johnell O, De Laet C, Jönsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473
Johnell O (1997) The socioeconomic burden of fractures: today and in the 21st century. Am J Med 103:20S–25S
Kanis JA, Johnell O, de Laet C, Jönsson B, Odén A, Ogelsby AK (2002 ) International variations in hip fracture probabilities: implications for assessment guidelines. J Bone Miner Res 17(7):1237–1244
Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289
Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413
Felsenberg D, Silman AJ, Lunt M et al (2002) Incidence of vertebral fracture in Europe: results from the European Prospective Osteoprosis Study (EPOS). J Bone Miner Res 17(4):716
Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D, Cummings SR (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996
Fujiwara S, Mizuno S, Ochi Y, Sasaki H, Kodama K, Russell WJ, Hosoda Y (1991) The incidence of thoracic vertebral fractures in a Japanese population: Hiroshima and Nagasaki, 1958–86. J Clin Epidemiol 44:1007–1014
Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800
Silverman SL, Minshall ME, Shen W, Harper KD, Xie S (2001) Health-related quality of life subgroup of the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 44:2611–2619
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 8:291–297
Ensrud KE, Thompson DE, Cauley JA, Nevitt MC, Kado DM, Hochberg MC, Santora AC, Black DM (2000) Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J Am Geriatr Soc 48(3):241–249
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 14:61–68
Kanis JA, Odén A, Johnell O, De Laet C, Jönsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15(2):108–112
Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15(3):175–179
de Laet CE, van Hout BA, Burger H, Weel AE, Hofman A, Pols HA (1999) Incremental cost of medical care after hip fracture and first vertebral fracture: the Rotterdam study. Osteoporos Int 10:66–72
Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, Ernster VL, Cummings SR (1992) Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 117:1016–1037
Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA III, Berger M (2000) Patients with prior fractures have an increased risk of future fracture: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739
Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15(1):38–42
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Johnell, O., Kanis, J. Epidemiology of osteoporotic fractures. Osteoporos Int 16 (Suppl 2), S3–S7 (2005). https://doi.org/10.1007/s00198-004-1702-6
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DOI: https://doi.org/10.1007/s00198-004-1702-6