Osteoporosis International

, Volume 23, Issue 7, pp 1859–1865

Mortality after vertebral fracture in Korea

Analysis of the National Claim Registry
  • Y.-K. Lee
  • S. Jang
  • S. Jang
  • H. J. Lee
  • C. Park
  • Y.-C. Ha
  • D.-Y. Kim
Original Article

Abstract

Summary

The present study evaluates the incidence and mortality of vertebral fractures in Korea, using data from the Health Insurance Review Assessment Service, which includes nationwide information entrusted by Korean government.

Introduction

A vertebral compression fracture is a serious complication associated with osteoporosis of the spine. We evaluated the incidence of vertebral fracture and subsequent mortality in South Korea, using nationwide data from the Health Insurance Review and Assessment Service (HIRA).

Methods

All new visits or admissions to clinics or hospitals for fractures were recorded in nationwide cohort by the Korean HIRA using International Classification of Disease, tenth Revision (ICD-10) code. The incidence of vertebral fracture and excess mortality associated with vertebral fracture were evaluated, in men and women aged 50 years or more between 2005 and 2008. Standardized mortality ratio (SMR) was calculated to determine excess mortality associated with vertebral fracture.

Results

The crude overall incidence of vertebral fractures was 984 per 100,000 person years from 2005 to 2008. The overall mortality rate at 3 months, 6 months, 1 year, and 2 years after vertebral fracture in men (5.56%, 9.41%, 14.6%, and 20.61%, respectively) were higher than that in women (2.41%, 4.36%, 7.16%, and 10.48%, respectively). In both genders, the age-specific mortality rates were more than those of the general population. The SMR was highest during the first 3 months and gradually declined to 2.53 in men and 1.86 in women at the 2-year period.

Conclusions

The incidence of vertebral fracture in South Korea was comparable with other countries such as Switzerland, and the mortality after vertebral fracture is higher than that of normal populations. The incidence of osteoporotic vertebral fracture and following high mortality are likely to become serious socioeconomic problems.

Keywords

Incidence Mortality Osteoporosis Vertebral fracture 

References

  1. 1.
    Cheung G, Chow E, Holden L, Vidmar M, Danjoux C, Yee AJ, Connolly R, Finkelstein J (2006) Percutaneous vertebroplasty in patients with intractable pain from osteoporotic or metastatic fractures: a prospective study using quality-of-life assessment. Can Assoc Radiol J 57:13–21PubMedGoogle Scholar
  2. 2.
    Salaffi F, Cimmino MA, Malavolta N, Carotti M, Di Matteo L, Scendoni P, Grassi W (2007) The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: the IMOF study. J Rheumatol 34:1551–1560PubMedGoogle Scholar
  3. 3.
    Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMedGoogle Scholar
  4. 4.
    Ensrud KE, Thompson DE, Cauley JA, Nevitt MC, Kado DM, Hochberg MC, Santora AC 2nd, 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 48:241–249PubMedGoogle Scholar
  5. 5.
    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 353:878–882PubMedCrossRefGoogle Scholar
  6. 6.
    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 14:61–68PubMedCrossRefGoogle Scholar
  7. 7.
    Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561PubMedCrossRefGoogle Scholar
  8. 8.
    Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112PubMedCrossRefGoogle Scholar
  9. 9.
    Lau E, Ong K, Kurtz S, Schmier J, Edidin A (2008) Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Jt Surg Am 90:1479–1486CrossRefGoogle Scholar
  10. 10.
    Bouza C, Lopez T, Palma M, Amate JM (2007) Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 18:649–657PubMedCrossRefGoogle Scholar
  11. 11.
    Gong HS, Oh WS, Chung MS, Oh JH, Lee YH, Baek GH (2009) Patients with wrist fractures are less likely to be evaluated and managed for osteoporosis. J Bone Jt Surg Am 91:2376–2380CrossRefGoogle Scholar
  12. 12.
    Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM (2005) Fasting serum glucose level and cancer risk in Korean men and women. JAMA 293:194–202PubMedCrossRefGoogle Scholar
  13. 13.
    Sung SK, Lee SG, Lee KS, Kim DS, Kim KH, Kim KY (2009) First-year treatment adherence among outpatients initiating antihypertensive medication in Korea: results of a retrospective claims review. Clin Ther 31:1309–1320PubMedCrossRefGoogle Scholar
  14. 14.
    Kang HY, Yang KH, Kim YN, Moon SH, Choi WJ, Kang DR, Park SE (2010) Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data. BMC Publ Health 10:230CrossRefGoogle Scholar
  15. 15.
    Korean Statistical Information Service. http://www.kosis.kr. Accessed Nov 24 2008
  16. 16.
    Richmond J, Aharonoff GB, Zuckerman JD, Koval KJ (2003) Mortality risk after hip fracture. J Orthop Trauma 17:53–56PubMedCrossRefGoogle Scholar
  17. 17.
    Tsuboi M, Hasegawa Y, Suzuki S, Wingstrand H, Thorngren KG (2007) Mortality and mobility after hip fracture in Japan: a ten-year follow-up. J Bone Jt Surg Br 89:461–466CrossRefGoogle Scholar
  18. 18.
    Ulm K (1990) A simple method to calculate the confidence interval of a standardized mortality ratio (SMR). Am J Epidemiol 131:373–375PubMedGoogle Scholar
  19. 19.
    Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428PubMedCrossRefGoogle Scholar
  20. 20.
    Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244PubMedCrossRefGoogle Scholar
  21. 21.
    Lippuner K, Johansson H, Kanis JA, Rizzoli R (2009) Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. Osteoporos Int 20:1131–1140PubMedCrossRefGoogle Scholar
  22. 22.
    Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMedCrossRefGoogle Scholar
  23. 23.
    Ioannidis G, Papaioannou A, Hopman WM, Akhtar-Danesh N, Anastassiades T, Pickard L, Kennedy CC, Prior JC, Olszynski WP, Davison KS, Goltzman D, Thabane L, Gafni A, Papadimitropoulos EA, Brown JP, Josse RG, Hanley DA, Adachi JD (2009) Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. CMAJ 181:265–271PubMedCrossRefGoogle Scholar
  24. 24.
    Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15:38–42PubMedCrossRefGoogle Scholar
  25. 25.
    Sanders KM, Seeman E, Ugoni AM, Pasco JA, Martin TJ, Skoric B, Nicholson GC, Kotowicz MA (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247PubMedCrossRefGoogle Scholar
  26. 26.
    Sakuma M, Endo N, Oinuma T, Endo E, Yazawa T, Watanabe K, Watanabe S (2008) Incidence and outcome of osteoporotic fractures in 2004 in Sado City, Niigata Prefecture, Japan. J Bone Miner Metab 26:373–378PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • Y.-K. Lee
    • 1
  • S. Jang
    • 5
  • S. Jang
    • 6
  • H. J. Lee
    • 2
  • C. Park
    • 2
  • Y.-C. Ha
    • 3
  • D.-Y. Kim
    • 4
  1. 1.Department of Orthopaedic SurgerySeoul National University Bundang HospitalSeoulSouth Korea
  2. 2.Health Insurance Review and Assessment ServiceSeoulSouth Korea
  3. 3.Department of Orthopaedic SurgeryChung-Ang University College of MedicineSeoulSouth Korea
  4. 4.Department of Nuclear MedicineKyung Hee University HospitalSeoulSouth Korea
  5. 5.Inje University College of PharmacyGyeongsangnam-doSouth Korea
  6. 6.Graduate School of Public HealthSeoul National UniversitySeoulSouth Korea

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