Department of Orthopedic Surgery, Inha University College of Medicine, Incheon, South Korea.
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Sungnam, South Korea.
Arch Osteoporos. 2017 Nov 9;12(1):100. doi: 10.1007/s11657-017-0395-3.
This study demonstrated increased mortality following sacral insufficiency fractures as with other major osteoporotic fractures. The 6-month mortality rate was 9.8%, the 1-year mortality rate was 17.5%, and the 3-year mortality rate was 25.5%. Sex- and age-adjusted standardized mortality ratio increased after fractures.
There are no data about mortality after sacral insufficiency fractures. The purposes of this study were to investigate the mortality rate among sacral insufficiency fracture patients and to identify risk factors associated with mortality.
This is a retrospective cohort study of patients diagnosed with sacral insufficiency fracture via radiological exam in a single institute from 2001 to 2014, excluding patients with pathological sacral fracture due to metastasis or primary tumor. Mortality and its predisposing factors were analyzed based on a review of electronic medical records and mortality data provided by the Korean Statistical Information Service. Kaplan-Meier survival analysis and Cox regression analysis were used for statistical analysis.
A total of 325 patients were included (275 women and 50 men). The mean age at the time of diagnosis was 69.4 years. One hundred and forty patients (43.1%) had a history of malignancy, and 71 patients (21.8%) had undergone pelvic radiation therapy before fracture diagnosis. Twenty-one patients (6.5%) underwent sacroplasty, and the others underwent conservative management after fracture diagnosis. The mean follow-up was 51.5 months, and a total of 101 patients died at the final follow-up. The 6-month mortality rate was 9.8%, the 1-year mortality rate was 17.5%, and the 3-year mortality rate was 25.5%. Sex- and age-adjusted standardized mortality ratio (SMR) increased after fractures. The overall SMR is 8.9 at 3 months decreasing to 4.5 at 2 years. Multivariable Cox regression analysis showed that significant factors associated with increased mortality were male gender, malignancy history, lumbosacral fusion with distal fusion level S1, stroke history, low total femur bone mineral density score, and low body mass index.
Like other types of osteoporotic fractures, sacral insufficiency fractures are associated with increased mortality.
与其他主要骨质疏松性骨折一样，骶骨不足骨折后死亡率增加。6 个月的死亡率为 9.8%，1 年的死亡率为 17.5%，3 年的死亡率为 25.5%。骨折后，男女和年龄调整后的标准化死亡率均增加。
目前尚无关于骶骨不足性骨折后死亡率的数据。本研究的目的是调查骶骨不足性骨折患者的死亡率，并确定与死亡率相关的危险因素。
这是一项对 2001 年至 2014 年期间在一家医院通过放射学检查诊断为骶骨不足性骨折的患者进行的回顾性队列研究，排除因转移或原发性肿瘤导致病理性骶骨骨折的患者。根据电子病历和韩国统计信息服务提供的死亡率数据，对死亡率及其相关因素进行分析。采用 Kaplan-Meier 生存分析和 Cox 回归分析进行统计学分析。
共纳入 325 例患者（275 例女性和 50 例男性）。诊断时的平均年龄为 69.4 岁。140 例（43.1%）有恶性肿瘤病史，71 例（21.8%）在骨折诊断前接受过骨盆放疗。21 例（6.5%）接受了骶骨成形术，其余患者在骨折诊断后接受了保守治疗。平均随访时间为 51.5 个月，最终随访时共有 101 例患者死亡。6 个月的死亡率为 9.8%，1 年的死亡率为 17.5%，3 年的死亡率为 25.5%。骨折后，男女和年龄调整后的标准化死亡率（SMR）增加。总体 SMR 在 3 个月时为 8.9，在 2 年时降至 4.5。多变量 Cox 回归分析显示，与死亡率增加相关的显著因素为男性、恶性肿瘤病史、腰骶融合伴远端融合水平 S1、中风病史、股骨总骨密度评分低和低体重指数。
与其他类型的骨质疏松性骨折一样，骶骨不足性骨折与死亡率增加有关。
