Proximal bone fractures caused by osteoporosis in older adults can cause significant risk of premature mortality, according to research presented at the American College of Rheumatology Annual Meeting in San Francisco.
Research conducted by Lyn March, MD, PhD, from the Kolling Institute of Bone and Joint Research and Sydney’s Royal North Shore Hospital, and colleagues showed that in addition to hip fractures, many other kinds of osteoporosis-related fractures doubled the rate of death.1
“Health professionals have been aware for some time that having a hip fracture when you are older increases your risk of dying in 1 to 2 years after the fracture, but we have not been so aware that other fractures could increase this risk as well,” Dr March said in a press release.
The researchers analyzed data from 125 174 older women and 113 499 older men with a mean age of 63 years from the 45 & Up Study from 2006 to 2008 in New South Wales, Australia. They identified fractures and deaths by linking these data with information from the Emergency Department Data Collection, Admitted Patient Data Collection, and Registry of Births, Deaths & Marriages. The average follow-up period was 5.7 years.
During the study period, a total of 14 827 fractures (9,145 in women and 5,682 in men) and 15 621 deaths were reported. Having an incident fracture doubled mortality rates: for men, 15.7 deaths occurred for every 1000 person-years during the follow-up period, which increased to 33.0 deaths for every 1000 person-years after a fracture. For women, 7.9 deaths occurred for every 1000 person-years, which increased to 19.0 deaths for every 1000 person-years after a fracture. This is the largest study of its kind to show an increased risk of death from fractures.
“We were surprised to find that almost all fractures (apart from fingers and toes) in the elderly were associated with increased risk of dying when compared to other men and women of the same age who had not had a fracture,” said Dr March in a statement. “Common fractures like spinal fractures that cause older people to stoop over; arm, collarbone, and wrist fractures from a simple fall; or pelvic fractures from a trip on the stairs or a slip on the ice all increase the risk of the sufferer dying in the next few years.”
The researchers note that their investigation highlights the need for further study into why these osteoporosis-related fractures cause an increased risk of death and the need to treat osteoporosis as a serious condition. Even though one-third of fall-related deaths are attributed to low bone density, osteoporosis is not always well managed or treated, most likely because there is a lack of awareness about how dangerous osteoporotic fractures can be, the researchers suspect.
Summary and Clinical Applicability
Osteoporotic fractures are those occurring from a fall from a standing height or less, without major trauma. This study found that in addition to hip fractures, fractures of the spine, shoulder, wrist, or clavicle can lead to a significantly increased risk of death.1 Apart from bone mineral density (BMD), other risk factors of osteoporotic fractures include prolonged glucocorticoid therapy, parental history of hip fracture, cigarette smoking, and excess alcohol intake.2
1. March L, Chen W, Simpson JM, et al. Premature mortality due to fractures in a population-based prospective cohort study of 238,673 older women and men. Presented at: 2015 ACR/ARHP Annual Meeting. November 6-11, 2015; San Francisco, California. Abstract 3173.
2. Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002; 359:1929.
This article originally appeared on Clinical Pain Advisor