Center for Next Generation of Community Health, Chiba University Hospital, 1-8-15 Inohana, Chuo-ku, Chiba City, Chiba 260-0856, Japan; Department of Orthopaedic Surgery, JCHO Funabashi Central Hospital, 6-13-10 Kaijin, Funabashi City, Chiba 260-8670, Japan.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
J Orthop Sci. 2024 Nov;29(6):1477-1482. doi: 10.1016/j.jos.2023.10.013. Epub 2023 Nov 18.
Osteoporosis is a global issue with a worldwide prevalence of 18.3%, and the presence of coexisting fragility fractures can reduce the survival rate by approximately 20%. In Japan, the prevalence of osteoporosis is estimated to be 12.8 million, and the annual occurrence of hip fractures is approximately 193,400. Remarkably, coexisting hip or spinal fragility fractures caused by slight external force meet the Japanese diagnostic criterion for osteoporosis regardless of bone mineral density. However, only 191 deaths due to osteoporosis were published in 2021 in Japan. With the concern that some cases of hip and spinal fragility fractures were assigned an underlying cause of death of traumatic fracture instead of osteoporosis, this study aimed to elucidate the actual number of deaths due to osteoporosis in Japan.
We used the data from Japan in 2018. First, the number of deaths due to osteoporosis and hip or spinal fractures was reviewed using published vital statistics. Second, we calculated the number of elderly deaths (age ≥80 years) resulting from hip or spinal fractures caused by falls on the same level using data from approximately 1.4 million annual individual death certificates. Combining the above data, the actual number of deaths due to osteoporosis was estimated.
Only 190 deaths due to osteoporosis were reported in the published data. The individual certificate data revealed 3437 elderly deaths due to hip or spinal fractures caused by falls on the same level, which could meet the criteria of osteoporotic fragility fractures. Accordingly, the estimated number of deaths caused by osteoporosis was calculated as 3,627, approximately 19 times the published value.
After researching the individual death certificate data focusing on the coexisting hip or spinal fragility fracture, it was implied that osteoporosis may have a higher mortality rate in Japan than what is published.
骨质疏松症是一个全球性问题，全球患病率为 18.3%，同时存在脆性骨折会使生存率降低约 20%。在日本，骨质疏松症的患病率估计为 1280 万，每年髋部骨折的发生约为 193400 例。值得注意的是，由轻微外力引起的同时存在髋部或脊柱脆性骨折，无论骨密度如何，均符合日本骨质疏松症的诊断标准。然而，2021 年在日本仅公布了 191 例骨质疏松症死亡病例。由于担心一些髋部和脊柱脆性骨折病例被归因于创伤性骨折而不是骨质疏松症作为根本死因，本研究旨在阐明日本骨质疏松症的实际死亡人数。
我们使用了 2018 年日本的数据。首先，通过已公布的生命统计数据，审查了骨质疏松症和髋部或脊柱骨折导致的死亡人数。其次，我们使用大约 140 万份年度个人死亡证明中的数据，计算了因跌倒在同一水平而导致髋部或脊柱骨折的 80 岁以上老年人的死亡人数。结合上述数据，估算了骨质疏松症导致的实际死亡人数。
已公布的数据仅报告了 190 例骨质疏松症死亡病例。个人证书数据显示，因跌倒在同一水平而导致髋部或脊柱骨折的 80 岁以上老年人死亡人数为 3437 例，这些病例可能符合骨质疏松性脆性骨折的标准。因此，估算的骨质疏松症导致的死亡人数为 3627 例，约为公布值的 19 倍。
在研究了重点关注同时存在髋部或脊柱脆性骨折的个人死亡证明数据后，表明骨质疏松症在日本的死亡率可能高于已公布的数据。
