Hospitalization with Vertebral Fracture among the Aged: A National Population-Based Study, 1986–1989

Jacobsen, Steven J.; Cooper, Cyrus; Gottlieb, Mark S.; Goldberg, Jack; Yahnke, David P.; Melton, L. Joseph

doi:10.1097/00001648-199211000-00009

Cited by 109 publications

(45 citation statements)

References 16 publications

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“…This is evidenced by the fact that fracture incidence rates in this community are 3 times higher [18] than reported from the only comparable study [41]. Indeed, even the vertebral fracture incidence rates in this community are much greater than those from other populations [41][42][43][44][45][46]. Also, there was considerable follow-up and a large number of subsequent fractures, which provided adequate statistical power.…”

Section: Discussionmentioning

confidence: 82%

Vertebral Fractures Predict Subsequent Fractures

Melton¹,

Atkinson²,

Cooper³

et al. 1999

Osteoporosis International

431

184

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This population-based study documents an increase in most types of fractures following the occurrence of a clinically recognized vertebral fracture among 820 Rochester, Minnesota, residents. During 4349 person-years of follow-up, 896 new fractures were observed. Relative to incidence rates in the community, there was a 2.8-fold increase in the risk of any fracture, which was greater in men (standardized incidence ratio (SIR), 4.2; 95% CI, 3.2-5.3) than women (SIR, 2.7; 95% CI, 2.4-3.0). The estimated cumulative incidence of any fracture after 10 years was 70%. The greatest increase in risk was for subsequent fractures of the axial skeleton, in particular a 12.6-fold increase (95% CI, 11-14) in additional vertebral fractures. There was a lesser increase in most limb fractures, including a 2.3-fold increase (95% CI, 1.8-2.9) in hip fractures and a 1.6-fold increase (95% CI, 1.01-2.4) in distal forearm fractures. There was a slightly greater association with distal forearm fractures among those whose first vertebral fracture occurred before age 70 years but a similar relationship with hip fractures, including cervical and intertrochanteric hip fractures separately, regardless of age at the initial vertebral fracture. There was also an equivalent increase in subsequent fracture risk whether the initial vertebral fracture was attributed to severe or moderate trauma. These data show that vertebral fractures represent an important risk factor for fractures in general, not just those of the spine and hip.

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Section: Discussionmentioning

confidence: 82%

Vertebral Fractures Predict Subsequent Fractures

Melton¹,

Atkinson²,

Cooper³

et al. 1999

Osteoporosis International

431

184

View full text Add to dashboard Cite

show abstract

“…It has been known for at least 40 years that fracture risk is lower among African-American (AA) than white men and women in the United States [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Furthermore, even with fewer fractures observed, a lower proportion of them are attributed to osteoporosis among those of African heritage [16].…”

Section: Introductionmentioning

confidence: 99%

Variations in Bone Density among Persons of African Heritage

Melton¹,

Marquez

Achenbach³

et al. 2002

Osteoporos Int

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The epidemiology of bone loss in populations of African heritage is still poorly known. We compared a convenience sample of 47 African-American (AA) residents of Rochester, Minnesota (32 women, 15 men) and 66 recent immigrants from Somalia (all women) with 684 white subjects (349 women, 335 men) previously recruited from an age-stratified random sample of community residents. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 for white subjects and the QDR 4500 for the others; the instruments were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 18% higher in AA ( p<0.001) and 4% lower in Somali ( p = 0.147) than white women. Femoral neck BMD was 27% higher in AA women but also 11% greater in Somali women (both p<0.001) compared with whites. Lumbar spine BMD was 6% higher ( p = 0.132) and femoral neck BMD 21% higher ( p<0.001) in AA than white men. No Somali men were studied. After correcting for bone size differences, both lumbar spine ( p<0.01) and femoral neck BMAD ( p<0.001) were greater for Somali than white women, but the difference between Somali and AA women persisted. Lumbar spine and femoral neck BMAD values also remained significantly greater for AA women (both p<0.001) and men ( p<0.05; p<0.001) compared with whites. Weight was associated with BMAD at both skeletal sites in all groups, but adjustment for differences in weight did not reduce the discrepancy in BMAD values between Somali and AA women or between the latter group and whites. This heterogeneity among different ethnic groups of African heritage may provide an opportunity for research to better explain race-specific differences in bone metabolism.

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“…Administrative databases in different countries have documented average stays for vertebral fractures of between 9.6 and 29.4 days [12][13][14][15][16], suggesting a significant worldwide burden. What remains unclear is whether this burden is related to other health problems coexisting with vertebral fractures.…”

Section: Introductionmentioning

confidence: 99%

Lengthy Hospitalization Associated with Vertebral Fractures Despite Control for Comorbid Conditions

Παπαϊωάννου¹,

Adachi²,

Parkinson³

et al. 2001

Osteoporosis International

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This study established whether length of hospital stay (LOS) in Canadians 50 years and older is attributable to their vertebral fractures versus comorbid conditions. The study used a case-control design and data in the Canadian Institute for Health Information (CIHI) database on hospital discharges in Ontario, Alberta, and British Columbia between April 1, 1996 and March 31, 1997. Patients with vertebral fractures were identified by International Classification of Diseases (ICD-9) codes. LOS constituted the dependent measure in a multivariate linear regression that calculated the independent contributions to LOS by vertebral fractures while controlling for: age, gender, province, discharged deceased, hip fractures, all other fractures, motor vehicle accidents, all other injuries, and the major disorder classifications in ICD-9. Mean LOS for all patients admitted for vertebral fractures was 10.1 days. LOS attributed solely to vertebral fractures was 4.8 days based on a 50-year-old woman with no comorbid conditions, and 6.1 days based on a 75-year-old woman. Of 18 health conditions, vertebral fractures were among the top 3 in accounting for LOS, along with hip fractures and mental disorders which accounted for 5.9 days and 6.1 days in a 50-year-old woman. Among patients admitted for other problems, comorbid vertebral fractures added 2.1 days. These findings indicate that hospital stays for vertebral fractures are lengthy despite control for comorbidity.

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Hospitalization with Vertebral Fracture among the Aged: A National Population-Based Study, 1986–1989

Cited by 109 publications

References 16 publications

Vertebral Fractures Predict Subsequent Fractures

Vertebral Fractures Predict Subsequent Fractures

Variations in Bone Density among Persons of African Heritage

Lengthy Hospitalization Associated with Vertebral Fractures Despite Control for Comorbid Conditions

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