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Association between mortality risk and the number, location, and sequence of subsequent fractures in the elderly

Authors
 S-B Lee  ;  Y Park  ;  D-W Kim  ;  J-W Kwon  ;  J-W Ha  ;  J-H Yang  ;  B H Lee  ;  K-S Suk  ;  S-H Moon  ;  H-S Kim  ;  H-M Lee 
Citation
 OSTEOPOROSIS INTERNATIONAL, Vol.32(2) : 233-241, 2021-02 
Journal Title
 OSTEOPOROSIS INTERNATIONAL 
Issue Date
2021-02
MeSH
Aged ; Cohort Studies ; Female ; Hip Fractures* ; Humans ; Male ; Proportional Hazards Models ; Risk Factors ; Spinal Fractures* ; Spine
Keywords
Hip fracture ; Mortality risk ; Osteoporosis ; Subsequent fracture ; Vertebral fracture
Abstract
The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk. Introduction: It is unclear whether subsequent fractures or a certain location and sequence of subsequent fractures are associated with mortality risk in the elderly. We aimed to investigate the relationship between subsequent fractures and mortality risk. Methods: Using the Korean National Health Insurance Research Database, we analyzed the cohort data of 24,756 patients aged > 60 years who sustained fractures between 2002 and 2013. Cox regression was used to assess the mortality risk associated with the number, locations, and sequences of subsequent fractures. Results: Mortality hazard ratios (HRs) for women and men were shown to be associated with the number of subsequent fractures (one, 1.63 (95% confidence interval [CI], 1.48-1.80) and 1.42 (95% CI, 1.28-1.58); two, 1.75 (95% CI, 1.47-2.08) and 2.03 (95% CI, 1.69-2.43); three or more, 2.46(95% CI, 1.92-3.15) and 1.92 (95% CI, 1.34-2.74), respectively). For women, the mortality risk was high when hip (HR, 2.49; 95% CI, 1.80-3.44) or vertebral (HR, 1.40; 95% CI, 1.03-1.90) fracture occurred as a second fracture. Compared with a single hip fracture, there was a high mortality risk in the group with hip fracture after the first vertebral fracture (HR, 2.90; 95% CI, 1.86-4.54), followed by vertebral fracture after the first hip fracture (HR, 1.90; 95% CI, 1.12-3.22). Conclusion: The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk.
Full Text
https://link.springer.com/article/10.1007/s00198-020-05602-x
DOI
10.1007/s00198-020-05602-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji-Won(권지원) ORCID logo https://orcid.org/0000-0003-4880-5310
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Suk, Kyung Soo(석경수) ORCID logo https://orcid.org/0000-0003-0633-2658
Yang, Jae Ho(양재호) ORCID logo https://orcid.org/0000-0001-7421-2805
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181894
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