Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study

被引：359

作者：

Ioannidis, George ^{[1
]}

Papaioannou, Alexandra ^{[1
]}

Hopman, Wilma M. ^{[4
]}

Akhtar-Danesh, Noori ^{[2
]}

Anastassiades, Tassos ^{[5
]}

Pickard, Laura ^{[1
]}

Kennedy, Courtney C. ^{[1
]}

Prior, Jerilynn C. ^{[6
]}

Olszynski, Wojciech P. ^{[7
]}

Davison, Kenneth S. ^{[8
]}

Goltzman, David ^{[9
]}

Thabane, Lehana ^{[3
]}

Gafni, Amiran ^{[3
]}

Papadimitropoulos, Emmanuel A. ^{[10
]}

Brown, Jacques P. ^{[8
]}

Josse, Robert G. ^{[11
]}

Hanley, David A. ^{[12
]}

Adachi, Jonathan D. ^{[1
]}

机构：

[1] McMaster Univ, Dept Med, Hamilton, ON, Canada

[2] McMaster Univ, Dept Nursing, Hamilton, ON, Canada

[3] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada

[4] Queens Univ, Dept Epidemiol & Community Hlth, Kingston, ON, Canada

[5] Queens Univ, Dept Med, Kingston, ON K7L 3N6, Canada

[6] Univ British Columbia, Dept Med, Vancouver, BC, Canada

[7] Univ Saskatchewan, Dept Med, Saskatoon, SK S7N 0W0, Canada

[8] Univ Laval, Dept Med, Ste Foy, PQ G1K 7P4, Canada

[9] McGill Univ, Dept Med, Montreal, PQ, Canada

[10] Eli Lilly & Co, Outcomes Res, Toronto, ON, Canada

[11] Univ Toronto, Dept Med, Toronto, ON, Canada

[12] Univ Calgary, Dept Med, Calgary, AB, Canada

来源：

CANADIAN MEDICAL ASSOCIATION JOURNAL | 2009年 / 181卷 / 05期

基金：

加拿大健康研究院;

关键词：

HIP FRACTURE; VERTEBRAL FRACTURE; EXCESS MORTALITY; OLDER WOMEN; HEALTH; CAMOS; RISK; MEN;

D O I：

10.1503/cmaj.081720

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. Methods: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from across Canada participated in a 5-year observational cohort study. Incident fractures were identified on the basis of validated self-report and were classified by type (vertebral, pelvic, forearm or wrist, rib, hip and "other"). We subdivided fracture groups by the year in which the fracture occurred during follow-up; those occurring in the fourth and fifth years were grouped together. We examined the relation between the time of the incident fracture and death. Results: Compared with participants who had no fracture during follow-up, those who had a vertebral fracture in the second year were at increased risk of death (adjusted hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.1-6.6); also at risk were those who had a hip fracture during the first year (adjusted HR 3.2, 95% CI 1.4-7.4). Among women, the risk of death was increased for those with a vertebral fracture during the first year (adjusted HR 3.7, 95% CI 1.1-12.8) or the second year of follow-up (adjusted HR 3.2, 95% CI 1.2-8.1). The risk of death was also increased among women with hip fracture during the first year of follow-up (adjusted HR 3.0, 95% CI 1.0-8.7). Interpretation: Vertebral and hip fractures are associated with an increased risk of death. Interventions that reduce the incidence of these fractures need to be implemented to improve survival.

引用

页码：265 / 271

页数：7

共 24 条

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The association between osteoporotic fractures and health-related quality of life as measured by the Health Utilities Index in the Canadian Multicentre Osteoporosis Study (CaMos) [J].