06/25/2009 - Articles

Fracture linked to mortality risk

By: Susan Aldridge, medical journalist, PhD

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Men and women having a fracture caused by osteoporosis are at increased risk of mortality during the years that follow. If they have a second fracture, then this increased risk persists.

Summary

Hip, vertebral and major fractures pose a risk of increased mortality during the following five years, according to a new study. And a further fracture prolongs the risk for another five years. Therefore, hip fractures are not the only type of fracture to be concerned about.

Introduction

Osteoporosis, or weakening of the bone, is a condition on the increase in an aging population. It is associated with an increase in the risk of fracture. We already know that a hip fracture can be a serious event, raising the risk of mortality in the years following. Less is known of the risks associated with other types of fracture.

What was done

Researchers at St Vincent's Hospital, Sydney, Australia, looked at the long-term risk of death - up to 18 years - after all types of osteoporosis-associated fractures in a group of men and women aged 60 or more. There were 2,245 women and 1,760 men in the group. The participants sustained a fracture between April 1989 and May 2007. Among women, there were 952 fractures, followed by 461 deaths, and among men there were 343 fractures and 197 deaths.

What was found

In comparison with the general population, hip, vertebral and major fractures - but not minor fractures - were associated with increased mortality for five years post-fracture. Minor fractures were linked to increased mortality in those aged over 75. After five years, mortality decreased but the risk linked to hip fracture remained elevated for 10 years. Those who survived the ten years had a mortality risk no greater than the general population. And a subsequent fracture increased mortality risk three to four times for a further five years.

What this study means

Fractures of all kinds can pose a risk of mortality to a person with osteoporosis. Therefore, more should be done on the part of doctor and patient to prevent falls that lead to these fractures. We do not know why fractures increase mortality - for women, the study suggests there could be an underlying factor predisposing to both fractures and mortality. For men, there may be some factor related to the fracture event itself.

Source

Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women D. Bliuc, ND. Nguyen,  et al, Journal of the American Medical Association, February 4 2009, vol. 301, pp. 513--521

Created on: 02/13/2009
Reviewed on: 06/25/2009

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