Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 32(9), 1802-1810, 2017
Population-Wide Impact of Non-Hip Non-Vertebral Fractures on Mortality
Thach Tran, Dana Bliuc, Tineke van Geel
Jonathan D Adachi, Claudie Berger, Joop P. van den Bergh, John A Eisman, Piet Geusens, David Goltzman, S M Kaiser, Christopher S Kovacs, Lisa Langsetmo, Jerilynn C Prior, Tuan V Nguyen, David A Hanley, Jacqueline R Center, Joop van den Bergh, Robert G Josse, Stephanie M Kaiser
Data on long-term consequences of non-hip non-vertebral (NHNV) fractures, accounting for approximately two-thirds of all fragility fractures, are scanty. Our study aimed to quantify the population-wide impact of NHNV fractures on mortality. The national population-based prospective cohort study (Canadian Multicentre Osteoporosis Study) included 5526 community dwelling women and 2163 men aged 50 years or older followed from July 1995 to September 2013. Population impact number was used to quantify the average number of people for whom one death would be attributable to fracture and case impact number to quantify the number of deaths out of which one would be attributable to a fracture. There were 1370 fragility fractures followed by 296 deaths in women (mortality rate: 3.49; 95% CI, 3.11 to 3.91), and 302 fractures with 92 deaths in men (5.05; 95% CI, 4.12 to 6.20). NHNV fractures accounted for three-quarters of fractures. In women, the population-wide impact of NHNV fractures on mortality was greater than that of hip and vertebral fractures because of the greater number of NHNV fractures. Out of 800 women, one death was estimated to be attributable to a NHNV fracture, compared with one death in 2000 women attributable to hip or vertebral fracture. Similarly, out of 15 deaths in women, one was estimated to be attributable to a NHNV fracture, compared with one in over 40 deaths for hip or vertebral fracture. The impact of forearm fractures (ie, one death in 2400 women and one out of 42 deaths in women attributable to forearm fracture) was similar to that of hip, vertebral, or rib fractures. Similar, albeit not significant, results were noted for men. The study highlights the important contribution of NHNV fractures on mortality because many NHNV fracture types, except for the most distal fractures, have serious adverse consequences that affect a significant proportion of the population.
non-hip non-vertebral fracture mortality population impact, fragility fracture mortality community dwelling older adults, Prior JC fracture mortality Canadian Multicentre Osteoporosis Study, NHNV fracture population attributable mortality, forearm fracture mortality risk compared hip vertebral, CaMos prospective cohort fracture outcomes, population impact number fracture attributable death, osteoporosis fracture long-term mortality risk women men, non-hip non-vertebral fracture epidemiology population-based, fragility fracture case impact number mortality
PMID 28256011 28256011 DOI 10.1002/jbmr.3118 10.1002/jbmr.3118
Cite this article
Tran, T., Bliuc, D., van Geel, T., Adachi, J. D., Berger, C., van den Bergh, J., Eisman, J. A., Geusens, P., Goltzman, D., Hanley, D. A., Josse, R. G., Kaiser, S. M., Kovacs, C. S., Langsetmo, L., Prior, J. C., Nguyen, T. V., & Center, J. R. (2017). Population-Wide Impact of Non-Hip Non-Vertebral Fractures on Mortality. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 32(9), 1802-1810. https://doi.org/10.1002/jbmr.3118
Tran T, Bliuc D, van Geel T, Adachi JD, Berger C, van den Bergh J, et al. Population-Wide Impact of Non-Hip Non-Vertebral Fractures on Mortality. J Bone Miner Res. 2017;32(9):1802-1810. doi:10.1002/jbmr.3118
Tran, T., et al. "Population-Wide Impact of Non-Hip Non-Vertebral Fractures on Mortality." Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, vol. 32, no. 9, 2017, pp. 1802-1810.
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