Mortality risk after the first occurrence of osteoporotic vertebral compression fractures in the general population: A nationwide cohort study

Abstract

Osteoporotic vertebral compression fractures (OVCF) can cause severe pain, changes in balance, gait velocity, muscle fatigue, risk of falls, and subsequent fractures. Thus, OVCF significantly lowers the individual’s health-related quality of life. Additionally, OVCF may increase patient mortality rates. However, studies on post-OVCF mortality are limited. This study aimed to evaluate mortality risk after the first occurrence of OVCF in the general population using a nationwide dataset from the Korean National Health Insurance System. We identified 291,203 newly diagnosed patients with OVCF and 873,609 patients without OVCF at a ratio of 1:3 matched by sex and age between 2010 and 2012. We investigated the latent characteristics of patients’ demographic information and chronic comorbidities that could affect mortality when diagnosed with OVCF. By comparing the cohort data, the hazard ratio for subsequent mortality in patients with OVCF was calculated and adjusted based on several risk factors. Despite adjusting for demographic characteristics and chronic comorbidities, the risk of mortality was 1.22 times higher in the OVCF cohort than in the control group. Multivariate analysis showed that male sex, old age, low-income status, and high Charlson Comorbidity Index were associated with a higher risk of mortality. In addition, the presence of chronic comorbidities, including diabetes mellitus, ischemic heart disease, stroke, chronic obstructive pulmonary disease, cancer, and end-stage renal disease, was shown to increase the risk of mortality. This population-based cohort study showed that newly diagnosed OVCF significantly increased the subsequent risk of mortality. Moreover, post-OVCF mortality is influenced by demographic characteristics and chronic comorbidities.