Mortality and Cause of Death in Patients With Vertebral Fractures

Spine - Tập 45 Số 5 - Trang E280-E287 - 2020
Hyo Geun Choi1,2, Joon Kyu Lee3, Songyong Sim4,5,6, Miyoung Kim7,5,6
1Department of Otorhinolaryngology–Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
2Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
3Department of Orthopaedic Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
4Department of Statistics, Hallym University, Chuncheon, Republic of Korea
5Songyong Sim, PhD, Department of Statistics, Hallym University, Hallymro 1, Chuncheon, Gangwon-do, 24252, Republic of Korea
6reprint requests to Miyoung Kim, MD, PhD, Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea
7Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Republic of Korea

Tóm tắt

Study Design. A retrospective study using the Korean Health Insurance Review and Assessment Service—National Sample Cohort was performed. Objective. To determine the rate and causes of mortality in vertebral fracture patients. Summary of Background Data. Vertebral fractures are associated with increased mortality in prior studies. Methods. Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, and region of residence. Finally, 21,759 vertebral fracture participants and 87,036 control participants were analyzed. The index date was the date of diagnosis of vertebral fracture; participants from the control group were followed from the same index date as their matched counterparts. The follow-up duration was the index date to the death date or the last date of study (December 31, 2013). Patients were followed until death or censoring of the data. Death was ascertained in the same period, and causes of death were grouped into 12 classifications according to the Korean Standard Classification of Disease. A stratified Cox proportional hazards model was used. Results. The adjusted hazard ratio (HR) for mortality of vertebral fracture was 1.28 (P < 0.001) with the higher adjusted HR in younger patients. Mortalities caused by neoplasms; neurologic, circulatory, respiratory, digestive, and muscular diseases; and trauma were higher in the vertebral fracture group (P < 0.05), with muscular disease showing the highest odds ratio for mortality. Conclusion. Vertebral fractures were associated with increased mortality in Korean. Disease in muscuoskeletal system and connective tissue that possibly be associated with the fractures was most responsible for elevated death rates following vertebral fracture. Our findings may help caregivers provide more effective care, ultimately decreasing the mortality rate of vertebral fracture patients. Level of Evidence: 3

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Spine

Tập 45 Số 5

E280-E287

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