TY - JOUR
T1 - Population-based study of survival after osteoporotic fractures
AU - Cooper, Cyrus
AU - Atkinson, Elizabeth J.
AU - Jacobsen, Steven J.
AU - O'fallon, W. Michael
AU - Melton, L. Joseph
N1 - Funding Information:
Received for publication September 14, 1992, and in final form January 15, 1993. Abbreviation: Cl, confidence interval. From the Department of Health Sciences Research, Mayo Clinic and Foundation, 200 First Street, S W , Rochester, MN 55905 Reprint requests to Dr. L. J. Melton ID, Section of Clinical Epidemiology, at this address. This work was supported in part by research grants AG-04875 and AR-30582 from the National Institutes of Health, United States Public Health Service Dr. Cooper was supported by a Travelling Fellowship from the Medical Research Council of Great Britain The authors appreciate the ass4Stance of Nancy Houar in the analysis of the data, of Diane McQjIlen for coding the death certificates, and of Mary Roberts and Sondra Buehler for help in preparing the manuscript.
PY - 1993/5/1
Y1 - 1993/5/1
N2 - Vertebral fractures are the most frequent of the fractures associated with osteoporosis, yet little is known of their impact on health in the United States. To aid in this understanding, the authors examined the survival rate of 335 residents of Rochester, Minnesota, who had an initial radiologic diagnosis of vertebral fracture between 1985 and 1989. Seventy-six died during 809 person-years of follow-up. The overall survival rate was worse than expected, and diverged steadily from expected values throughout the course of the study. At 5 years after diagnosis, the estimated survival was 61% compared with an expected value of 76% (relative survival = 0.81, 95% confidence interval (Cl) 0.70-0.92). The 5-year relative survival after a hip fracture in Rochester was a comparable 0.82 (95% Cl 0.77-0.87), but there was a much greater excess of deaths within the first 6 months as compared with patients with vertebral fractures. The 5-year relative survival rate after a distal forearm fracture was 1.00 (95% Cl 0.95-1.05). Clinically diagnosed vertebral fractures are rarely fatal, and the reduced survival seen subsequently could relate to comorbid conditions. Nonetheless, the excess mortality should be accounted for in assessing the public health impact of osteoporosis.
AB - Vertebral fractures are the most frequent of the fractures associated with osteoporosis, yet little is known of their impact on health in the United States. To aid in this understanding, the authors examined the survival rate of 335 residents of Rochester, Minnesota, who had an initial radiologic diagnosis of vertebral fracture between 1985 and 1989. Seventy-six died during 809 person-years of follow-up. The overall survival rate was worse than expected, and diverged steadily from expected values throughout the course of the study. At 5 years after diagnosis, the estimated survival was 61% compared with an expected value of 76% (relative survival = 0.81, 95% confidence interval (Cl) 0.70-0.92). The 5-year relative survival after a hip fracture in Rochester was a comparable 0.82 (95% Cl 0.77-0.87), but there was a much greater excess of deaths within the first 6 months as compared with patients with vertebral fractures. The 5-year relative survival rate after a distal forearm fracture was 1.00 (95% Cl 0.95-1.05). Clinically diagnosed vertebral fractures are rarely fatal, and the reduced survival seen subsequently could relate to comorbid conditions. Nonetheless, the excess mortality should be accounted for in assessing the public health impact of osteoporosis.
KW - Colles' fracture
KW - Hip fractures
KW - Mortality
KW - Osteoporosis
KW - Spinal fractures
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U2 - 10.1093/oxfordjournals.aje.a116756
DO - 10.1093/oxfordjournals.aje.a116756
M3 - Article
C2 - 8317445
AN - SCOPUS:0027324969
SN - 0002-9262
VL - 137
SP - 1001
EP - 1005
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 9
ER -