Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 1;45(5):E280-E287.
doi: 10.1097/BRS.0000000000003264.

Mortality and Cause of Death in Patients With Vertebral Fractures: A Longitudinal Follow-Up Study Using a National Sample Cohort

Hyo Geun Choi  1   2 , Joon Kyu Lee  3 , Songyong Sim  4 , Miyoung Kim  5
Affiliations

Mortality and Cause of Death in Patients With Vertebral Fractures: A Longitudinal Follow-Up Study Using a National Sample Cohort

Hyo Geun Choi et al. Spine (Phila Pa 1976). .

Abstract

Study design: A retrospective study using the Korean Health Insurance Review and Assessment Service-National Sample Cohort was performed.

Objective: To determine the rate and causes of mortality in vertebral fracture patients.

Summary of background data: Vertebral fractures are associated with increased mortality in prior studies.

Methods: Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, and region of residence. Finally, 21,759 vertebral fracture participants and 87,036 control participants were analyzed. The index date was the date of diagnosis of vertebral fracture; participants from the control group were followed from the same index date as their matched counterparts. The follow-up duration was the index date to the death date or the last date of study (December 31, 2013). Patients were followed until death or censoring of the data. Death was ascertained in the same period, and causes of death were grouped into 12 classifications according to the Korean Standard Classification of Disease. A stratified Cox proportional hazards model was used.

Results: The adjusted hazard ratio (HR) for mortality of vertebral fracture was 1.28 (P < 0.001) with the higher adjusted HR in younger patients. Mortalities caused by neoplasms; neurologic, circulatory, respiratory, digestive, and muscular diseases; and trauma were higher in the vertebral fracture group (P < 0.05), with muscular disease showing the highest odds ratio for mortality.

Conclusion: Vertebral fractures were associated with increased mortality in Korean. Disease in muscuoskeletal system and connective tissue that possibly be associated with the fractures was most responsible for elevated death rates following vertebral fracture. Our findings may help caregivers provide more effective care, ultimately decreasing the mortality rate of vertebral fracture patients.

Level of evidence: 3.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Gold DT. The clinical impact of vertebral fractures: quality of life in women with osteoporosis. Bone 1996; 18:185S–189S.
    1. Salaffi F, Cimmino MA, Malavolta N, et al. The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: the IMOF study. J Rheumatol 2007; 34:1551–1560.
    1. Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician 2004; 69:111–116.
    1. Hasserius R, Karlsson MK, Nilsson BE, et al. 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 2003; 14:61–68.
    1. Ross PD, Davis JW, Epstein RS, et al. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 1991; 114:919–923.

MeSH terms