Mortality Following the Diagnosis of a Vertebral Compression Fracture in the Medicare Population

Lau, Edmund; Ong, Kevin; Kurtz, Steven; Schmier, Jordana; Edidin, Av
July 2008
Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1479
Academic Journal
Background: Vertebral compression fractures in women are associated with increased mortality, but the generality of this finding, as a function of age, sex, ethnicity, and region, among the entire elderly population in the United States remains unclear. The objective of this study was to assess the survival of the Medicare population with vertebral compression fractures. Methods: We conducted a retrospective data analysis of Medicare claims generated by a 5% sample of all Medicare enrollees from 1997 through 2004. The patient sample consisted of all 97,142 individuals with a new diagnosis of vertebral compression fracture from 1997 through 2004. Controls were matched for age, sex, race, and Medicare buy-in status, with a five-to-one control-case ratio. The survival of a patient was measured from the earliest date of a new fracture until death or until the end of the study. The patients with a fracture were compared with the controls by calculation of the mortality rates, with use of Kaplan-Meier analysis and the Cox regression method. Demographic subpopulation analysis and analysis by comorbidity levels were performed as well. Results: Medicare patients with a vertebral fracture had an overall mortality rate that was approximately twice that of the matched controls. The survival rates following a fracture diagnosis, as estimated with the Kaplan-Meier method, were 53.9%, 30.9%, and 10.5% at three, five, and seven years, respectively, which were consistently and significantly lower than the rates for the controls. The mortality risk following a fracture was greater for men than for women. The difference in mortality between the patients with a vertebral compression fracture and the controls was greatest when the patients were younger at the time of the fracture; this difference declined as the age at the time of the fracture increased. Conclusions: This study establishes the mortality risk associated with vertebral fractures for elderly patients of all ages and ethnicities and both sexes in the Medicare population; however, it does not imply a causal relationship. The difference in mortality between patients with a fracture and controls is higher than previously reported, even after controlling for comorbidities.


Related Articles

  • Patient Risk Factors, Operative Care, and Outcomes Among Older Community-Dwelling Male Veterans with Hip Fracture. Radcliff, Tiffany A.; Henderson, William G.; Stoner, Tamara J.; Khuri, Shukri F.; Dohm, Michael; Hutt, Evelyn // Journal of Bone & Joint Surgery, American Volume;Jan2008, Vol. 90-A Issue 1, p34 

    Background: Although more than 1200 hip fracture repairs are performed in United States Department of Veterans Affairs hospitals annually, little is known about the relationship between perioperative care and short-term outcomes for veterans with hip fracture. The purpose of the present study...

  • Don't miss underlying reason for elder's fall.  // ED Nursing;Mar2010, Vol. 13 Issue 5, p58 

    If your elderly patient reports a fall injury, carefully assess for fractures and identify what caused the fall. To improve care: • suspect loss of consciousness; • assess the ability to walk; • look for abrasions, bruising, or deformities.

  • Elder with fracture? Take these steps.  // ED Nursing;Mar2010, Vol. 13 Issue 5, p59 

    The article presents information on how to deal with fractures of elders. Lori Dowell, clinical educator at Oakwood Hospital and Medical Center in Dearborn, Michigan states that an elderly patient with fall injury should be given an open airway. Dowell mentions that supplemental oxygen may also...

  • Osteoporotische Frakturen am proximalen Humerus. Lill, H.; Ellwein, A.; Katthagen, C.; Voigt, C. // Der Chirurg;Oct2012, Vol. 83 Issue 10, p858 

    Fractures of the proximal humerus are typical osteoporotic fractures of the elderly with an increasing incidence. Computed tomography (CT) with 3D reconstruction plays a more and more decisive role in the diagnostics because of an improved understanding of fractures in 3D images. The resulting...

  • Osteoporotische Frakturen des proximalen Femurs. Bonnaire, F.; Straßberger, C.; Kieb, M.; Bula, P. // Der Chirurg;Oct2012, Vol. 83 Issue 10, p882 

    Proximal femoral fractures in the elderly are still increasing and are almost always associated with osteoporosis. Especially the over 80-year-olds are increasing and at risk in this respect. In the treatment of these patients new knowledge has been achieved over the last years. An...

  • The epidemic of ankle fractures in the elderly – is surgical treatment warranted? Salai, M.; Dudkiewicz, I.; Novikov, I.; Amit, Y.; Chechick, A. // Archives of Orthopaedic & Trauma Surgery;Sep2000, Vol. 120 Issue 9, p511 

    Ankle fractures in the elderly are extremely common (up to 184 fractures per 100,000 persons per year, and of these approximately 20%–30% occur in the elderly). The medical literature contains no research that has investigated ankle fractures in the elderly. A prospective, randomised...

  • A life-breaking event: early experiences of the consequences of a hip fracture for elderly people. Zidén, Lena; Wenestam, Claes-Göran; Hansson-Scherman, Marianne // Clinical Rehabilitation;Sep2008, Vol. 22 Issue 9, p801 

    Objective: To explore and describe the consequences of an acute hip fracture as experienced by home-dwelling elderly people shortly after discharge from hospital. Design: Semi-structured interviews using the phenomenographic method. Subjects and setting: Eighteen subjects were interviewed in...

  • Results of treatment of simple unstable uncomplicated lower leg shaft fractures treated operatively and nonoperatively. Dzankovic, Fuad; Avdic, Dijana; Macic-Dzankovic, Amra // HealthMed;Mar2010, Vol. 4 Issue 1, p95 

    For the purpose of this research, 60 patients were observed with simple unstable uncomplicated fracture of lower leg ,divided into two groups: group treated nonoperatively and group treated operatively subdivided on subgroup of patients treated with compression plate and screw and subgroup of...

  • Hip protectors are ineffective for preventing hip and pelvic fractures. Van Schoor, N. M.; Smit, J. H.; Twisk, J. W. R. // BMJ: British Medical Journal (International Edition);8/2/2003, Vol. 327 Issue 7409, p238 

    Reports on a randomly controlled, non blinded, trial to determine if hip protectors help prevent hip fractures in elderly people. Findings which did not show a statistically significant difference between the intervention and control groups.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics