Fractures as predictors of excess mortality in the aged—A population-based study with a 12-year follow-up

Piirtola, Maarit; Vahlberg, Tero; Löppönen, Minna; Räihä, Ismo; Isoaho, Raimo; Kivelä, Sirkka‐Liisa

doi:10.1007/s10654-008-9289-4

Cited by 75 publications

(78 citation statements)

References 55 publications

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“…Humerus fractures have a substantial impact on personal function and well-being and are one of the leading causes of excessive mortality among the elderly (1)(2)(3). A humerus fracture is often caused by a fall directly on the shoulder or arm (4), and the proximal part of the humerus fracture is commonly encountered in patients with osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008

Kim

Szabo

Marder

2012

Arthritis Care & Research

293

148

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Objective. To evaluate the occurrence of emergency department (ED) visits due to humerus fractures in the US. Methods. We analyzed the 2008 Nationwide Emergency Department Sample, which contained approximately 28 million ED records. We identified the cases of interest using diagnostic codes for proximal, shaft, and distal humerus fractures. Results. In 2008, approximately 370,000 ED visits in the US resulted from humerus fractures. Proximal humerus fractures were the most common, accounting for 50% of humerus fractures. The incidence rate of proximal humerus fractures followed the shape of an exponential function in the age groups 40 -84 years for women (R 2 ‫؍‬ 97.9%) and 60 -89 years for men (R 2 ‫؍‬ 98.2%). After the exponential increase in these age intervals, the growth rate of proximal humerus fracture slowed and eventually decreased. The peak occurrence of distal humerus fractures was in children ages 5-9 years; however, elderly women had an increased risk. As the baby boomer generation ages, unless fracture prevention programs improve, more than 490,000 ED visits due to humerus fractures are expected in 2030 when the youngest of the baby boomers turn age 65 years. Conclusion. Compared to epidemiologic studies in Japan and European countries, the incidence rates of humerus fractures are substantially higher in the US. The high incidence rate of humerus fractures in the expanding elderly population may contribute to the recent trend of rapid increase in shoulder arthroplasty in the US. Rigorous safety measures to reduce falls and improved preventive treatments of osteoporosis are needed.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008

Kim

Szabo

Marder

2012

Arthritis Care & Research

293

148

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“…More than 90% of hip fractures among older adults are caused by falls (1). Due to their frequency, hip fractures are one of the most challenging public health concerns, often leading to considerable consequences, including disability (2) and premature death (3,4). Ongoing pain and limited physical mobility can severely compromise quality of life (5).…”

Section: Introductionmentioning

confidence: 99%

Hip fractures in the United States: 2008 nationwide emergency department sample

Kim

Meehan²,

Blumenfeld

et al. 2012

Arthritis Care & Research

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Objective. To evaluate the recent epidemiology of hip fractures in the US. Methods. We identified hip fracture cases from the 2008 Nationwide Emergency Department Sample, which contains more than 28 million emergency department (ED) records. Results. In 2008, approximately 341,000 (95% confidence interval 323,000 -358,000) patients visited EDs with hip fractures. Of those, 90% were age >60 years. Between ages 60 -85 years, the risk of fracture doubled for every 5-to 6-year increase in age. However, the hip fracture risk increased slowly after age 85 years. The overall trochanteric-to-cervical fracture ratio was nearly 2:1. The risk of trochanteric fracture increased faster with age compared with the risk of cervical fracture. At age 85 years, the rates of trochanteric and cervical fractures (per 100,000) were 1,300 and 700, respectively, among women and 800 and 500, respectively, among men. Conclusion. The slowed growth of hip fracture risk after age 85 years suggests that the eldest old group may have a distinct hip fracture risk. Our study showed that trochanteric fractures were twice as common as cervical fractures. Because trochanteric fractures are more closely related to severe and generalized bone loss than cervical fractures, we hypothesize that the high incidence rate of trochanteric fractures in the US suggests that osteoporosis is a health problem that is linked to hip fracture. In addition to improved safety measures to reduce falls, rigorous preventive treatments of osteoporosis may be needed.

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“…Osteoporotic fractures are an important cause of mortality and morbidity for older people (Piirtola et al, 2008). One established risk factor for osteoporotic fracture is low bone mineral density (BMD), but falls risk is also important as are age, gender, race, diet and other lifestyle factors (Kanis et al, 2005;Dontas and Yiannakopoulos, 2007).…”

Section: Introductionmentioning

confidence: 99%

Beverage-specific alcohol intake and bone loss in older men and women: a longitudinal study

et al. 2011

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Background/Objectives: There is inconsistent evidence regarding the association between moderate alcohol consumption and bone mineral density (BMD). The aim of this study was to describe the associations between total and beverage-specific alcohol intake and bone loss in older men and women. Subject/Methods: A total of 862 randomly selected subjects (mean age 63 years, range 51-81, 51% men) were studied at baseline and 2 years later. BMD was assessed by dual-energy X-ray absorptiometry. Beverage specific and total alcohol intake was assessed by food-frequency questionnaire. Falls risk was determined using the short form Physiological Profile Assessment. Incident fractures were ascertained by questionnaire. Results: Total alcohol intake in men positively predicted change in BMD at the lumbar spine and hip (b ¼ 0.008% and 0.006% per year per gram, Po0.05) after adjustment for confounders, but there was no significant association between alcohol intake and change in BMD in women. Lumbar spine BMD at baseline was negatively associated with frequency of spirits/liquor drinking in men (b ¼ À0.01 g/cm 2 per category, P ¼ 0.045) and was positively associated with frequency of beer drinking (low alcohol) in women (b ¼ 0.034 g/cm 2 per category, P ¼ 0.002). Change in lumbar spine BMD was positively associated with the frequency of red wine drinking in men (b ¼ 0.08% per year per class, P ¼ 0.046). Neither beverage-specific nor total alcohol intake was associated with falls risk or fracture. Conclusions: Alcohol intake especially red wine might prevent bone loss in older men but not women, whereas low-alcohol beer may be protective in women and spirits/liquor may be deleterious in men.

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Fractures as predictors of excess mortality in the aged—A population-based study with a 12-year follow-up

Cited by 75 publications

References 55 publications

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008

Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008

Hip fractures in the United States: 2008 nationwide emergency department sample

Beverage-specific alcohol intake and bone loss in older men and women: a longitudinal study

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