Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea.
Spine (Phila Pa 1976). 2020 Mar 1;45(5):E280-E287. doi: 10.1097/BRS.0000000000003264.
A retrospective study using the Korean Health Insurance Review and Assessment Service-National Sample Cohort was performed.
To determine the rate and causes of mortality in vertebral fracture patients.
Vertebral fractures are associated with increased mortality in prior studies.
Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, and region of residence. Finally, 21,759 vertebral fracture participants and 87,036 control participants were analyzed. The index date was the date of diagnosis of vertebral fracture; participants from the control group were followed from the same index date as their matched counterparts. The follow-up duration was the index date to the death date or the last date of study (December 31, 2013). Patients were followed until death or censoring of the data. Death was ascertained in the same period, and causes of death were grouped into 12 classifications according to the Korean Standard Classification of Disease. A stratified Cox proportional hazards model was used.
The adjusted hazard ratio (HR) for mortality of vertebral fracture was 1.28 (P < 0.001) with the higher adjusted HR in younger patients. Mortalities caused by neoplasms; neurologic, circulatory, respiratory, digestive, and muscular diseases; and trauma were higher in the vertebral fracture group (P < 0.05), with muscular disease showing the highest odds ratio for mortality.
Vertebral fractures were associated with increased mortality in Korean. Disease in muscuoskeletal system and connective tissue that possibly be associated with the fractures was most responsible for elevated death rates following vertebral fracture. Our findings may help caregivers provide more effective care, ultimately decreasing the mortality rate of vertebral fracture patients.
本研究使用韩国健康保险审查和评估服务-国家样本队列进行了回顾性研究。
确定椎体骨折患者的死亡率和死亡率的原因。
先前的研究表明，椎体骨折与死亡率增加有关。
在 1125691 名患者中，我们收集了 2002 年至 2013 年间所有年龄段经历胸腰椎骨折的 23026 名患者的数据。将椎体骨折患者与对照组患者按年龄、组别、性别、收入和居住地进行 1:4 匹配。最终，分析了 21759 名椎体骨折患者和 87036 名对照组患者。索引日期为诊断为椎体骨折的日期；对照组的参与者从与匹配参与者相同的索引日期开始随访。随访时间为索引日期至死亡日期或研究结束日期（2013 年 12 月 31 日）。患者随访至死亡或数据截尾。同期确定死亡情况，并根据韩国疾病标准分类将死亡原因分为 12 类。使用分层 Cox 比例风险模型。
椎体骨折患者的死亡率调整后危险比（HR）为 1.28（P<0.001），年轻患者的调整后 HR 更高。椎体骨折组的肿瘤；神经、循环、呼吸、消化和肌肉疾病；以及创伤的死亡率更高（P<0.05），肌肉疾病的死亡率最高。
椎体骨折与韩国的死亡率增加有关。与骨折可能相关的肌肉骨骼系统和结缔组织疾病是导致椎体骨折后死亡率升高的主要原因。我们的研究结果可能有助于护理人员提供更有效的护理，最终降低椎体骨折患者的死亡率。
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