Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study.

Full Abstract

BACKGROUND: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. METHODS: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from across Canada participated in a 5-year observational cohort study. Incident fractures were identified on the basis of validated self-report and were classified by type (vertebral, pelvic, forearm or wrist, rib, hip and "other"). We subdivided fracture groups by the year in which the fracture occurred during follow-up; those occurring in the fourth and fifth years were grouped together. We examined the relation between the time of the incident fracture and death. RESULTS: Compared with participants who had no fracture during follow-up, those who had a vertebral fracture in the second year were at increased risk of death (adjusted hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.1-6.6); also at risk were those who had a hip fracture during the first year (adjusted HR 3.2, 95% CI 1.4-7.4). Among women, the risk of death was increased for those with a vertebral fracture during the first year (adjusted HR 3.7, 95% CI 1.1-12.8) or the second year of follow-up (adjusted HR 3.2, 95% CI 1.2-8.1). The risk of death was also increased among women with hip fracture during the first year of follow-up (adjusted HR 3.0, 95% CI 1.0-8.7). INTERPRETATION: Vertebral and hip fractures are associated with an increased risk of death. Interventions that reduce the incidence of these fractures need to be implemented to improve survival.

Author information

Author/s: Ioannidis, George (G); Papaioannou, Alexandra (A); Hopman, Wilma M (WM); Akhtar-Danesh, Noori (N); Anastassiades, Tassos (T); Pickard, Laura (L); Kennedy, Courtney C (CC); Prior, Jerilynn C (JC); Olszynski, Wojciech P (WP); Davison, Kenneth S (KS); Goltzman, David (D); Thabane, Lehana (L); Gafni, Amiran (A); Papadimitropoulos, Emmanuel A (EA); Brown, Jacques P (JP); Josse, Robert G (RG); Hanley, David A (DA); Adachi, Jonathan D (JD);

Affiliation: Department of Medicine, McMaster University, Hamilton, Ont. g.ioannidis(-atsign-)sympatico.ca

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne (CMAJ), published in Canada. (Language: eng)

Reference: 2009-Sep; vol 181 (issue 5) : pp 265-71

Dates: Created 2009/09/01; Completed 2009/09/29;

PMID: 19654194, status: MEDLINE (last retrieval date: 9/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: CMAJ. 2009 Sep 1;181(5):247-8. (PMID: 19654191)

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