Related Experiment Video
Updated: Mar 14, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Mortality associated with bone fractures in COPD patients
Yasuhiro Yamauchi1, Hideo Yasunaga2, Yukiyo Sakamoto1
1Department of Respiratory Medicine, Graduate School of Medicine.
Insights
COPD patients with bone fractures, especially hip fractures, face higher in-hospital mortality. Surgical intervention for hip fractures in COPD patients is linked to reduced mortality rates.
Area of Science:
- Geriatric Medicine
- Pulmonology
- Orthopedic Surgery
Background:
- Chronic Obstructive Pulmonary Disease (COPD) frequently coexists with osteoporosis.
- Bone fractures are common in COPD patients and can impact mortality.
- In-hospital mortality associated with bone fractures in COPD patients remains understudied.
Purpose of the Study:
- To investigate the in-hospital mortality of COPD patients experiencing bone fractures.
- To identify factors associated with in-hospital mortality in COPD patients with hip fractures.
Main Methods:
- Retrospective analysis of data from 5,975 COPD patients with bone fractures (hip, vertebra, shoulder, forearm).
- Data extracted from the Japanese Diagnosis Procedure Combination database (July 2010 - March 2013).
- Multivariable logistic regression used to identify mortality predictors in hip fracture patients.
Main Results:
- Hip fractures (n=4,059) were associated with higher in-hospital mortality (7.4%) compared to vertebral (5.2%), shoulder (3.9%), and forearm (1.3%) fractures.
- Surgical treatment for hip fractures significantly reduced mortality (aOR 0.43).
- Male sex, lower BMI, reduced consciousness, and comorbidities (pneumonia, lung cancer, CHF, liver, renal disease) increased mortality risk.
Conclusions:
- COPD patients with hip fractures exhibit higher in-hospital mortality than those with other fracture types.
- Surgical management of hip fractures in COPD patients is associated with better survival outcomes compared to conservative care.
Background And Objective:
COPD is well known to frequently coexist with osteoporosis. Bone fractures often occur and may affect mortality in COPD patients. However, in-hospital mortality related to bone fractures in COPD patients has been poorly studied. This retrospective study investigated in-hospital mortality of COPD patients with bone fractures using a national inpatient database in Japan.
Methods:
Data of COPD patients admitted with bone fractures, including hip, vertebra, shoulder, and forearm fractures to 1,165 hospitals in Japan between July 2010 and March 2013, were extracted from the Diagnosis Procedure Combination database. The clinical characteristics and mortalities of the patients were determined. Multivariable logistic regression analysis was also performed to determine the factors associated with in-hospital mortality of COPD patients with hip fractures.
Results:
Among 5,975 eligible patients, those with hip fractures (n=4,059) were older, had lower body mass index (BMI), and had poorer general condition than those with vertebral (n=1,477), shoulder (n=281), or forearm (n=158) fractures. In-hospital mortality was 7.4%, 5.2%, 3.9%, and 1.3%, respectively. Among the hip fracture group, surgical treatment was significantly associated with lower mortality (adjusted odds ratio, 0.43; 95% confidence interval, 0.32-0.56) after adjustment for patient backgrounds. Higher in-hospital mortality was associated with male sex, lower BMI, lower level of consciousness, and having several comorbidities, including pneumonia, lung cancer, congestive heart failure, chronic liver disease, and chronic renal failure.
Conclusion:
COPD patients with hip fractures had higher mortality than COPD patients with other types of fracture. Surgery for hip fracture was associated with lower mortality than conservative treatment.
More Related Videos
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:26COPD: Management Using Bronchodilators and Corticosteroids