Unveiling Hidden Threat: Osteoporotic Vertebral Fractures Linked to Increased Mortality

Osteoporotic vertebral compression fractures (OVCF) can unleash a cascade of health problems increasing the risk of falls and additional fractures. A groundbreaking study found that OVCF has debilitating effects, affects the quality of life, and significantly elevates the subsequent risk of mortality. 

The study was published in the journal PLOS ONE on September 14, 2023. 

With the ever-increasing geriatric population worldwide, the incidence of osteoporosis and osteoporotic fractures, such as spine, hip, wrist, and shoulder fractures, also is increasing. Osteoporotic vertebral compression fractures (OVCF) are the most common fragility fractures related to osteoporosis and tend to occur earlier than other major osteoporotic fractures, such as hip fractures. Due to limited data on the patient mortality rates and post-OVCF mortality rates, the research team led by Hee Jung Son conducted a nationwide cohort study to evaluate mortality risk after the first occurrence of OVCF in the general population. 

By harnessing a comprehensive nationwide dataset from the Korean National Health Insurance System, researchers identified a staggering 291,203 individuals newly diagnosed with OVCF between 2010 and 2012. To establish a basis for comparison, 873,609 individuals without OVCF were carefully selected as part of a control group. Notably, this selection process aimed to maintain an equal balance in terms of sex and age, with a matching ratio of 1:3. The researchers meticulously examined the underlying characteristics of patients, including their demographic information and chronic comorbidities as they can influence the mortality rates once an OVCF diagnosis was made. Through a rigorous analysis of the cohort data, researchers calculated the hazard ratio for subsequent mortality in patients with OVCF. 

Key findings: 

• Even after adjusting for demographic characteristics and chronic comorbidities, the findings were stark and unequivocal.
• The risk of mortality among individuals with OVCF was found to be 1.22 times higher than that of the control group.
• Male gender, advanced age, low-income status, and a high Charlson Comorbidity Index were all identified as factors associated with an increased risk of mortality among OVCF patients.
• Additionally, the presence of chronic comorbidities, including diabetes mellitus, ischemic heart disease, stroke, chronic obstructive pulmonary disease, cancer, and end-stage renal disease, further exacerbated the mortality risk.

Thus, these results underscored the severity of the issue, emphasizing that OVCF poses not only immediate health challenges but also potentially life-threatening consequences. This study serves as an urgent call to action. It not only illuminates the significant mortality risk associated with OVCF but also underscores the multifaceted nature of this threat, shaped by a range of demographic characteristics and chronic comorbidities. With these findings in hand, healthcare providers are better equipped to address the complex needs of patients grappling with OVCF, offering a ray of hope and a chance for improved care and outcomes for those affected by this condition.

Further reading: Son HJ, Park SJ, Kim JK, Park JS. Mortality risk after the first occurrence of osteoporotic vertebral compression fractures in the general population: A nationwide cohort study. PLoS One. 2023;18(9):e0291561. Published 2023 Sep 14. doi:10.1371/journal.pone.0291561