Proportions of fall-related and insufficiency-related vertebral fractures among hospitalized older patients
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Bastian Abel1,2,3, Rebekka Leonhardt4, Patrick Roigk4
1Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany. bastian.abel@rbk.de.
Abstract:
This study determined the proportions of fall-related and insufficiency-related vertebral fractures among 325 older hospitalized patients. The fracture etiology was determined by a comprehensive interview focusing on the circumstances at the onset of fracture-related pain. Falls were a markedly more frequent cause of vertebral fractures than insufficiency.
Purpose:
The majority of vertebral fractures in older adults occur either as insufficiency fracture or as a consequence of a fall. The objective of this study was to determine the proportions of fall-related and insufficiency-related fractures among patients hospitalized with clinically symptomatic vertebral fractures.
Methods:
This cross-sectional study included 325 hospitalized patients aged ≥ 65 years with vertebral fractures from three hospitals. The fracture etiology (fall-related vs. insufficiency-related) was determined using a comprehensive clinical interview that focused on the circumstances surrounding the initial onset of fracture-related pain. The proportion of these two etiologies was analyzed for all fractures, across different fracture locations, and within various strata of personal and functional parameters.
Results:
The mean age was 83 ± 6 years and 73% of patients were female. Among all vertebral fractures, 60.9% were classified as fall-related, 30.8% as insufficiency-related, and in 8.3% the exact etiology remained uncertain. Falls accounted for the majority of cervical vertebral fractures (88.2%) and were less common as an etiology in thoracic (54.8%) and lumbar (59.5%) fractures. A higher proportion of insufficiency fractures was observed in underweight patients (42.1%) compared to normal weight (24.6%) or overweight patients (28.9%). No statistically significant differences in vertebral fracture etiology were observed across strata of sex, vertebral fracture classification, care need, risk of a major osteoporotic fracture, or life-space mobility.
Conclusion:
The findings show that falls are a markedly more frequent cause of vertebral fractures than insufficiency-related fractures. This pattern is consistent across the overall study population and the strata of various variables.
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