Vertebral fractures and mortality in older women -: A prospective study
Vertebral fractures and mortality in older women -: A prospective study
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DOI：
10.1001/archinte.159.11.1215
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发表时间：
1999-06-14
影响因子：
--
通讯作者：
Cummings, SR
中科院分区：
文献类型：
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作者：
Kado, DM;Browner, WS;Cummings, SR
背景：骨质疏松性骨折，包括临床检测到的椎骨骨折，与死亡率增加相关。然而，只有三分之一的椎骨骨折得到诊断。目前尚不清楚椎骨骨折，无论临床上是否明显，是否与更高的死亡率相关。目的：检验普遍存在椎骨骨折的女性比没有骨折的女性死亡率更高的假设，并描述与椎骨骨折相关的死亡原因。设计：平均随访时间为 8.3 年的前瞻性队列研究。地点：美国的四个临床中心。参与者：总共 9575 名 65 岁或以上的女性并参加了骨质疏松性骨折研究。测量：通过射线照相形态测量测量椎体骨折；跟骨骨矿物质密度；人口统计、病史和生活方式变量；血压;和人体测量。在 606 名参与者的子集中，在第二次就诊时测量了胸椎曲度。主要结果指标：死亡率和特定原因死亡率的风险比。结果：在基线时，1915 名女性 (20.0%) 被诊断患有椎骨骨折。与未发生椎骨骨折的女性相比，发生 1 处或以上骨折的女性的年龄调整死亡率高出 1.23 倍（95% 置信区间，1.10-1.37）。死亡率随着椎骨骨折数量的增加而上升，从没有骨折的女性中每 1000 名女性年 19 例上升到有 5 处或更多骨折的女性中每 1000 名女性年 44 例（P 为趋势，
Background: Osteoporotic fractures, including clinically detected vertebral fractures, are associated with increased mortality. However, only one third of vertebral fractures are diagnosed. It is unknown whether vertebral fractures, whether clinically apparent or not, are associated with greater mortality.Objectives: To test the hypothesis that women with prevalent vertebral fractures have greater mortality than those without fractures and to describe causes of death associated with vertebral fractures.Design: Prospective cohort study with mean follow-up of 8.3 years.Setting: Four clinical centers in the United States.Participants: A total of 9575 women aged 65 years or older and enrolled in the Study of Osteoporotic Fractures.Measurements: Vertebral fractures by radiographic morphometry; calcaneal bone mineral density; demographic, medical history, and lifestyle variables; blood pressure; and anthropometric measures. In a subset of 606 participants, thoracic curvature was measured during a second clinic visit.Main Outcome Measures: Hazard ratios for mortality and cause-specific mortality.Results: At baseline, 1915 women (20.0%) were diagnosed as having vertebral fractures. Compared with women who did not have a vertebral fracture, women with 1 or more fractures had a 1.23-fold greater age-adjusted mortality rate (95% confidence interval, 1.10-1.37). Mortality rose with greater numbers of vertebral fractures, from 19 per 1000 woman-years in women with no fractures to 44 per 1000 woman-years in those with 5 or more fractures (P for trend,