PT  - JOURNAL ARTICLE
AU  - Ioannidis, George
AU  - Papaioannou, Alexandra
AU  - Hopman, Wilma M.
AU  - Akhtar-Danesh, Noori
AU  - Anastassiades, Tassos
AU  - Pickard, Laura
AU  - Kennedy, Courtney C.
AU  - Prior, Jerilynn C.
AU  - Olszynski, Wojciech P.
AU  - Davison, Kenneth S.
AU  - Goltzman, David
AU  - Thabane, Lehana
AU  - Gafni, Amiran
AU  - Papadimitropoulos, Emmanuel A.
AU  - Brown, Jacques P.
AU  - Josse, Robert G.
AU  - Hanley, David A.
AU  - Adachi, Jonathan D.
TI  - Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study
AID  - 10.1503/cmaj.081720
DP  - 2009 Sep 01
TA  - Canadian Medical Association Journal
PG  - 265--271
VI  - 181
IP  - 5
4099  - http://www.cmaj.ca/content/181/5/265.short
4100  - http://www.cmaj.ca/content/181/5/265.full
SO  - CMAJ2009 Sep 01; 181
AB  - Background: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. Methods: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from across Canada participated in a 5-year observational cohort study. Incident fractures were identified on the basis of validated self-report and were classified by type (vertebral, pelvic, forearm or wrist, rib, hip and “other”). We subdivided fracture groups by the year in which the fracture occurred during follow-up; those occurring in the fourth and fifth years were grouped together. We examined the relation between the time of the incident fracture and death. Results: Compared with participants who had no fracture during follow-up, those who had a vertebral fracture in the second year were at increased risk of death (adjusted hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.1–6.6); also at risk were those who had a hip fracture during the first year (adjusted HR 3.2, 95% CI 1.4–7.4). Among women, the risk of death was increased for those with a vertebral fracture during the first year (adjusted HR 3.7, 95% CI 1.1–12.8) or the second year of follow-up (adjusted HR 3.2, 95% CI 1.2–8.1). The risk of death was also increased among women with hip fracture during the first year of follow-up (adjusted HR 3.0, 95% CI 1.0–8.7). Interpretation: Vertebral and hip fractures are associated with an increased risk of death. Interventions that reduce the incidence of these fractures need to be implemented to improve survival.