Chronic Pancreatitis and Fracture: A Retrospective, Population-Based Veterans Administration Study

• Published in: Pancreas Vol. 45; no. 3; p. 355
• Main Authors: Munigala, Satish, Agarwal, Banke, Gelrud, Andres, Conwell, Darwin L
• Format: Journal Article
• Language: English
• Published: United States 01.03.2016
• Subjects: Adult; Age Factors; Aged; Chi-Square Distribution; Comorbidity; Female; Fractures, Bone - epidemiology; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Osteoporotic Fractures - epidemiology; Pancreatitis, Chronic - epidemiology; Population Surveillance - methods; Prevalence; Retrospective Studies; Risk Assessment - methods; Risk Assessment - statistics & numerical data; Risk Factors; Sex Factors; United States - epidemiology; United States Department of Veterans Affairs - statistics & numerical data
• ISSN: 1536-4828
• DOI: 10.1097/MPA.0000000000000381

There is increasing evidence that chronic pancreatitis (CP) is a risk factor for osteoporotic fracture, but data on males with CP and fracture prevalence are sparse. We determined the association of sex and age using a large Veterans Administration database. This was a retrospective analysis (1998-2007). Patients with CP (International Classification of Diseases code 577.1) and control subjects (without CP) were identified after exclusions and fracture prevalence (vertebral, hip, and wrist) were recorded. 453,912 Veterans Administration patients were identified (control subjects: 450,655 and patients with CP: 3257). Mean ages of control subjects and CP were 53.6 and 54.2 years (P < 0.014). Patients with CP had higher odds ratios of total fractures (2.35; 95% confidence interval [CI], 2.00-2.77), vertebral fracture 2.11 (95% CI, 1.44-3.01), hip fracture 3.49 (95% CI, 2.78-4.38), and wrist fracture 1.68 (95% CI, 1.29-2.18) when compared with control subjects. After adjusting for age group and etiology, patients with CP had increased odds of total fractures, vertebral fractures, and hip fractures (P < 0.05). In this male-predominate Veterans Administration study, patients with CP were at increased risk of osteoporotic fractures. The risk was higher for hip fracture (>3 times) in patients with CP compared with control subjects. All patients with CP older than 45 years, irrespective of sex, should be screened for bone mineral density loss.