Document Detail


Long-term mortality following fractures at different skeletal sites: a population-based cohort study.
MedLine Citation:
PMID:  23212281     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: This study aims to determine long-term survival following fractures due to any cause at each skeletal site.
METHODS: In a historical cohort study, 2,901 Olmsted County, MN, USA, residents ≥35 years old who experienced any fracture in 1989-1991 were followed passively for up to 22 years for death from any cause. Standardized mortality ratios (SMRs) compared observed to expected deaths.
RESULTS: During 38,818 person-years of follow-up, 1,420 deaths were observed when 1,191 were expected (SMR, 1.2; 95 % CI, 1.1-1.3). The overall SMR was greatest soon after fracture, especially among the men, but remained elevated for over a decade thereafter. Adjusting for age and sex, relative death rates were greater for pathological fractures and less for severe trauma fractures compared to the fractures due to no more than moderate trauma. In the latter group, long-term mortality was increased following fractures at many skeletal sites. After further adjustment for precipitating cause, overall SMRs were elevated not only following fractures at the traditional major osteoporotic sites (i.e., distal forearm, proximal humerus, thoracic/lumbar vertebrae, and proximal femur) combined (SMR, 1.2; 95 % CI, 1.1-1.3) but also following all other fracture types combined (SMR 1.2; 95 % CI, 1.1-1.4), excluding the hand and foot fractures not associated with any increased mortality.
CONCLUSIONS: The persistence of increased mortality long after the occurrence of a fracture has generally been attributed to underlying comorbidity, but this needs to be defined in much greater detail if specific opportunities are to be identified for reducing the excess deaths observed.
Authors:
L J Melton; S J Achenbach; E J Atkinson; T M Therneau; S Amin
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-12-05
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  24     ISSN:  1433-2965     ISO Abbreviation:  Osteoporos Int     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-17     Completed Date:  2013-10-31     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1689-96     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Female
Follow-Up Studies
Fractures, Bone / etiology,  mortality*
Humans
Male
Middle Aged
Minnesota / epidemiology
Osteoporotic Fractures / mortality
Sex Distribution
Time Factors
Grant Support
ID/Acronym/Agency:
P01 AG004875/AG/NIA NIH HHS; P01 AG04875/AG/NIA NIH HHS; R01 AG034676/AG/NIA NIH HHS; R01 AG034676/AG/NIA NIH HHS
Comments/Corrections

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