Osteoporosis International

, Volume 30, Issue 4, pp 837–843 | Cite as

Risk of osteoporosis and fracture in victims with burn injury

  • O. Kaewboonchoo
  • F.C. Sung
  • C.L. Lin
  • H.C. Hsu
  • C.T. KuoEmail author
Original Article



Osteoporosis is a well-known bone disorder affecting people worldwide. Patients with osteoporosis have an increased risk of bone fracture. This study provides new information on the risk of developing osteoporosis post burn injury and the risk of fracture among those with osteoporosis developed.


The relationship between burn injury and hip fracture risk is unclear. Population-based evaluation on relationships between burn injury and osteoporosis development and subsequent fractures is limited. We conducted a retrospective cohort study as the investigation.


From the insurance data of Taiwan, we established a cohort of 43,532 patients with a burn injury in 2000–2012 and a comparison cohort of 174,124 individuals without such an injury, frequency matched by sex, age, and diagnosis date. Both cohorts were followed up to the end of 2013 to evaluate the occurrence of osteoporosis and hip fracture.


The incidence of osteoporosis was greater in the burn cohort than in the comparison cohort (6.40 vs. 4.75 per 1,000 person-years) with an adjusted IRR of 1.35 (95% confidence interval = 1.32–1.39). The incidence rates in both cohorts were greater in women than in men, increased with age, income, and Charlson comorbidity index. Patients with burns involving 20%–49% of total body surface area and with burns confined to the lower/upper limbs had the greatest incidence rates, 8.32 and 8.58 per 1,000 person-years, respectively. Osteoporosis incidence increased further to 22.7 per 1,000 person-years for burn victims with comorbid diabetes. The risk of fracture was over five-fold greater for burn victims with osteoporosis developed than for comparisons without osteoporosis.


Patients who have a burn injury deserve prevention intervention to reduce the risk of osteoporosis and fracture.


Burn injury Diabetes Insurance claims data Osteoporosis Retrospective cohort study 


Funding information

This study was financially supported in parts by the Ministry of Health and Welfare in Taiwan (MOHW107-TDU-B-212-123004); China Medical University Hospital (CMU107-ASIA-19, DMR-107-192); Academia Sinica Stroke Biosignature Project (BM10701010021); MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-); Tseng-Lien Lin Foundation, Taichung, Taiwan; and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

Compliance with ethical standards

Because the surrogate identifications could protect privacy, no consents were required from persons selected in this retrospective cohort study. This study was approved by the Research Ethics Committee, China Medical University and Hospital.

Conflicts of interest


Human and animal rights and informed consent

This study used secondary data of insurance with surrogate identifications, requiring no consent.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • O. Kaewboonchoo
    • 1
  • F.C. Sung
    • 1
    • 2
    • 3
  • C.L. Lin
    • 3
  • H.C. Hsu
    • 4
  • C.T. Kuo
    • 1
    • 5
    Email author
  1. 1.Department of Public Health NursingMahidol University Faculty of Public HealthBangkokThailand
  2. 2.Department of Health Services AdministrationChina Medical University College of Public HealthTaichungTaiwan
  3. 3.Management Office for Health DataChina Medical University HospitalTaichungTaiwan
  4. 4.Department of Orthopedic SurgeryChina Medical University HospitalTaichungTaiwan
  5. 5.Department of Public HealthChina Medical University College of Public HealthTaichungTaiwan

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