Mortality risk higher after the first occurrence of osteoporotic vertebral compression fractures

1. Patients with a new diagnosis of osteoporotic vertebral compression fracture (OVCF) are at higher risk of mortality compared to their sex- and age-matched controls.

2. Factors that increase the risk of mortality amongst OVCF patients include: Male sex, older age, low-income, high Charlson Comorbidity Index, and medical comorbidities such as CHF, cancer, and stroke.

Evidence Rating Level: 2 (Good)

Osteoporotic vertebral compression fractures (OVCF) are one of the most common osteoporotic fractures. OVCFs can cause tremendous pain and instability, further increasing risk of falls. They may also increase the risk of mortality from complications of kyphosis, such as pulmonary disease. This current retrospective cohort study based in South Korea examined the mortality risk after first OVCF event. Data was analyzed from 2010 to 2012, where patients with a new diagnosis of OVCF were matched 1:3 to members of the general population, with the same sex and age. The mortality rate was compared between the two groups, and the demographics and comorbidities were also compared. In total, there were 291,203 OVCF patients and 873,609 control patients, with a median follow-up of 5.87 years. The mortality rate was 24.3% in the OVCF group and 19.6% in the control group, with a higher risk in OVCF patients (adjusted hazard ratio 1.22, 95% CI 1.20-1.33). The analysis of demographics and comorbidities found that OVCF patients who were male, more elderly, low-income, and with high Charlson Comorbidity Index were associated with greater mortality. Chronic comorbidities also increased the mortality risk, with congestive heart failure being the highest risk (HR 2.26, 95% CI 2.21-2.30), with cancer and stroke being the next highest-risk comorbidities. Overall, this study showed that patients with a new diagnosis of OVCF are at a higher risk of mortality than the sex and age matched general population.

Click to read the study in PLoSONE

Image: PD

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