Fractures Attributable to Osteoporosis: Report from the National Osteoporosis Foundation

Abstract

To assess the cost-effectiveness of interventions to prevent osteoporosis, it is necessary to estimate total health care expenditures for the treatment of osteoporotic fractures. Resources utilized for the treatment of many diseases can be estimated from secondary databases using relevant diagnosis codes, but such codes do not indicate which fractures are osteoporotic in nature. Therefore, a panel of experts was convened to make judgments about the probabilities that fractures of different types might be related to osteoporosis according to patient age, gender, and race. A three-round Delphi process was applied to estimate the proportion of fractures related to osteoporosis (i.e., the osteoporosis attribution probabilities) in 72 categories comprised of four specific fracture types (hip, spine, forearm, all other sites combined) stratified by three age groups (45-64 years, 65-84 years, 85 years and older), three racial groups (white, black, all others), and both genders (female, male). It was estimated that at least 90% of all hip and spine fractures among elderly white women should be attributed to osteoporosis. Much smaller proportions of the other fractures were attributed to osteoporosis. Regardless of fracture type, attribution probabilities were less for men than women and generally less for non-whites than whites. These probabilities will be used to estimate the total direct medical costs associated with osteoporosis-related fractures in the United States. (J Bone Miner Res 1997;12:16-23)

Etiology of lumbar lordosis and its pathophysiology: a review of the evolution of lumbar lordosis, and the mechanics and biology of lumbar degeneration

“…Up to 90% of spine and hip fractures in elderly women and 70% in elderly men may be attributed to osteoporosis. 133 Osteoporosis is defined as bone mineral density values that are more than 2.5 standard deviations below the young adult average. 209 Bone mineral density is the major determinant of bone strength and osteoporotic fracture risk.…”

Proportion of osteoporotic women remaining at risk for fracture despite adherence to oral bisphosphonates

“…Each year over 1.3 million fractures occur in the United States, the majority of which are due to age-related osteoporosis [1]. In 2010, 54 million adults age 50 and older in the United States were estimated to have osteoporosis or osteopenia as defined by BMD measurement [2].…”

Vertebroplasty for osteoporotic spine fracture: prevention and treatment

“…A loss of one standard deviation of bone mass doubles the risk of spine fractures [34,56,59]. It is estimated that 90% of hip and spine fractures occurring in the elderly are attributable to osteoporosis [45]. The consequences of such osteoporotic vertebral fractures are diverse and include back pain, functional limitations and impairment of mood [11,37,58].…”