Adverse Outcomes of Osteoporotic Fractures in the General Population

L. Joseph Melton

Research output: Contribution to journalArticle

308 Citations (Scopus)

Abstract

Osteoporotic fractures exact a terrible toll on the population with respect to morbidity and cost, and to a lesser extent mortality, which will increase dramatically with the growing elderly population. Attention has focused on the 12-20% excess deaths after hip fracture, but most are caused by underlying medical conditions unrelated to osteoporosis. More important is fracture-related morbidity. An estimated 10% of patients are disabled by hip fracture, and 19% require institutionalization, accounting for almost 140,000 nursing home admissions annually in this country. Distal forearm and vertebral fractures less commonly result in nursing home placement, but about 10% of postmenopausal women have vertebral deformities that cause chronic pain, and a substantial minority have poor function after forearm fracture. These fractures interfere greatly with the activities of daily living, and all of them can have a substantial negative impact on quality of life. Annual expenditures for osteoporotic fracture care in the United States ($17.5 million in 2002 dollars) are dominated by hip fracture treatment, but vertebral fractures, distal forearm fractures, and importantly, the other fractures related to osteoporosis contribute one-third of the total. Although all fracture patients are at increased risk of future fractures, few of them are currently treated for osteoporosis, and only a subset (i.e., those with vertebral fractures) are considered candidates for many clinical trials. Eligibility criteria should be expanded and fracture end-points generalized to acknowledge the overall burden of osteoporotic fractures.

Original languageEnglish (US)
Pages (from-to)1139-1141
Number of pages3
JournalJournal of Bone and Mineral Research
Volume18
Issue number6
DOIs
StatePublished - Jun 1 2003

Fingerprint

Osteoporotic Fractures
Hip Fractures
Forearm
Osteoporosis
Nursing Homes
Population
Morbidity
Institutionalization
Activities of Daily Living
Health Expenditures
Chronic Pain
Quality of Life
Clinical Trials
Costs and Cost Analysis
Mortality
Therapeutics

Keywords

  • Cost
  • Fractures
  • Morbidity
  • Mortality
  • Osteoporosis

ASJC Scopus subject areas

  • Surgery

Cite this

Adverse Outcomes of Osteoporotic Fractures in the General Population. / Melton, L. Joseph.

In: Journal of Bone and Mineral Research, Vol. 18, No. 6, 01.06.2003, p. 1139-1141.

Research output: Contribution to journalArticle

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