Mortality and incident vertebral fractures after 3Â years of follow-up among geriatric patients

• Published in: Osteoporosis international Vol. 24; no. 5; p. 1713
• Main Authors: van der Jagt-Willems, H C, Vis, M, Tulner, C R, van Campen, J P; C; M, Woolf, A D, van Munster, B C, Lems, W F
• Format: Journal Article
• Language: English
• Published: London Springer Nature B.V 01.05.2013
• Subjects: Cohort analysis; Comorbidity; Frailty; Geriatrics; Hospitals; Internal medicine; Mortality; Osteoporosis; Population-based studies; Quality of life; Radiography; Rheumatology; X-rays; Netherlands
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-012-2147-y

In a prospective cohort study of 395 geriatric outpatients, mortality after 3Â years was associated with prevalent vertebral fractures at baseline. The mortality risk was independently associated with the presence of three or more vertebral fractures at baseline. In the surviving patients, the risk of incident fractures was noteworthy, occurring in 26Â % of these patients. The purpose of this study is to determine mortality rate and the incidence of vertebral fractures in a geriatric outpatient group, during a 3-year follow-up period, in a teaching hospital in Amsterdam, The Netherlands. This study includes a prospective cohort study of 395 geriatric patients who had their baseline visit at a diagnostic day hospital in 2007 and 2008. They were invited for follow-up 3Â years later. Lateral X-rays of the lumbar spine and chest were performed at baseline and after 3Â years; vertebral fractures were scored in all patients according to the semi-quantitative method of Genant. After 3Â years, mortality was 46Â % and associated with prevalent vertebral fractures at baseline (odds ratio (OR), 1.83; 95Â % CI, 1.23â[euro]"2.74). The presence of three or more vertebral fractures at baseline was an independent risk factor for mortality (OR, 3.32; 95Â % CI, 1.56â[euro]"7.07). Other independently associated risk factors were greater age, higher co-morbidity score, and having more prescriptions. Higher cognitive capacity protected against mortality after 3Â years. In 72 patients, radiography was repeated. Nineteen patients (26Â %) had an incident radiographic vertebral fracture: 16 in those with a prevalent fracture, and 3 in those without a prevalent vertebral fracture at baseline. In geriatric outpatients, mortality after 3Â years was associated with prevalent vertebral fractures at baseline, and the mortality risk was independently associated with 3 or more vertebral fractures at baseline. In survivors, the risk of incident fractures was noteworthy, since these occurred in 26Â % of the patients, particularly in those with a prevalent vertebral fracture.[PUBLICATION ABSTRACT]