Opportunistically identifiable vertebral fractures on routine radiological imaging predict mortality: observational cohort study
Opportunistically identifiable vertebral fractures on routine radiological imaging predict mortality: observational cohort study
UNLABELLED: In men and women with opportunistically identifiable vertebral fractures (VFs) on routine CT scans including the chest and/or abdomen, the risk of death is 51% higher than in those with no VF on the CT scan, and 325% higher than an age- and sex-matched general population cohort.
PURPOSE: There is little knowledge about the risk of death in patients with VFs present on routine radiological imaging. We evaluated the risk of death in men and women aged 50 years or older with opportunistically identifiable VFs on routine CT scans and not treated with osteoporosis medications.
METHODS: Thoracic and lumbar VFs were identified through a blinded, two-step approach on CT scans performed as part of normal clinical care in a Danish hospital in 2010 or later. Subjects with VF were matched on age and sex against those with no VF (1:2-ratio) and a general population cohort (1:3-ratio), respectively, and followed for up to 7 years through the national Danish registers. Subjects treated with an osteoporosis medication in the year prior to baseline were excluded.
RESULTS: Subjects with VF had a significantly higher risk of death during follow-up as compared to subjects with no VF on the CT scan (adjusted hazard ratio [HR] 1.51 [95% confidence interval 1.27-1.79; p < 0.001]) and even more so when compared to the general population cohort (HR 4.25 [3.53-5.12; p < 0.001]). In subjects with versus without VF on the CT scan, the risk was higher in those with moderate or severe VF, in those with no malignancy prior to baseline, and in those with a lower Charlson comorbidity index score.
CONCLUSION: Subjects with VF available for identification on routine CT scans face a substantially increased risk of death. Opportunistic identification and reporting of VF is important to identify these patients to allow intervention if indicated.
Epidemiology, Mortality, Osteoporosis, Public health, Vertebral fracture
691-703
Skjødt, Michael Kriegbaum
9e1b6d51-3b42-4938-a2c3-31b488704416
Nicolaes, Joeri
53748c31-2c0f-4eee-b315-cb720403f42c
Smith, Christopher Dyer
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Olsen, Kim Rose
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Libanati, Cesar
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Abrahamsen, Bo
ea627e06-482e-479f-8631-5b0f3aec5d13
April 2024
Skjødt, Michael Kriegbaum
9e1b6d51-3b42-4938-a2c3-31b488704416
Nicolaes, Joeri
53748c31-2c0f-4eee-b315-cb720403f42c
Smith, Christopher Dyer
dba6c924-9083-4525-9e8a-30c05f609e69
Olsen, Kim Rose
1deb0114-5177-434e-859d-4729f1845e06
Libanati, Cesar
4e3b711d-453b-4f15-b175-3975d566b9c9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Abrahamsen, Bo
ea627e06-482e-479f-8631-5b0f3aec5d13
Skjødt, Michael Kriegbaum, Nicolaes, Joeri, Smith, Christopher Dyer, Olsen, Kim Rose, Libanati, Cesar, Cooper, Cyrus and Abrahamsen, Bo
(2024)
Opportunistically identifiable vertebral fractures on routine radiological imaging predict mortality: observational cohort study.
Osteoporosis International, 35 (4), .
(doi:10.1007/s00198-024-07017-4).
Abstract
UNLABELLED: In men and women with opportunistically identifiable vertebral fractures (VFs) on routine CT scans including the chest and/or abdomen, the risk of death is 51% higher than in those with no VF on the CT scan, and 325% higher than an age- and sex-matched general population cohort.
PURPOSE: There is little knowledge about the risk of death in patients with VFs present on routine radiological imaging. We evaluated the risk of death in men and women aged 50 years or older with opportunistically identifiable VFs on routine CT scans and not treated with osteoporosis medications.
METHODS: Thoracic and lumbar VFs were identified through a blinded, two-step approach on CT scans performed as part of normal clinical care in a Danish hospital in 2010 or later. Subjects with VF were matched on age and sex against those with no VF (1:2-ratio) and a general population cohort (1:3-ratio), respectively, and followed for up to 7 years through the national Danish registers. Subjects treated with an osteoporosis medication in the year prior to baseline were excluded.
RESULTS: Subjects with VF had a significantly higher risk of death during follow-up as compared to subjects with no VF on the CT scan (adjusted hazard ratio [HR] 1.51 [95% confidence interval 1.27-1.79; p < 0.001]) and even more so when compared to the general population cohort (HR 4.25 [3.53-5.12; p < 0.001]). In subjects with versus without VF on the CT scan, the risk was higher in those with moderate or severe VF, in those with no malignancy prior to baseline, and in those with a lower Charlson comorbidity index score.
CONCLUSION: Subjects with VF available for identification on routine CT scans face a substantially increased risk of death. Opportunistic identification and reporting of VF is important to identify these patients to allow intervention if indicated.
Text
s00198-024-07017-4
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More information
Accepted/In Press date: 3 January 2024
e-pub ahead of print date: 18 January 2024
Published date: April 2024
Additional Information:
Funding Information:
Open access funding provided by Zealand Region This is an investigator initiated study funded by a grant from the Region Zealand Health Scientific Research Foundation and by a collaborator grant from UCB Pharma/Amgen Inc. The lead author was supported by a PhD scholarship from the Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. CL and JN are UCB Pharma employees, and the manuscript was shared with UCB Pharma/Amgen Inc. for courtesy review prior to submission (from this review, comments on the manuscript were received from one of the authors [CL], who was also part of the courtesy review panel; beyond this, no comments were received). The other funders were not involved in the study.
Publisher Copyright:
© 2024, The Author(s).
Publisher Copyright:
© The Author(s) 2024.
Keywords:
Epidemiology, Mortality, Osteoporosis, Public health, Vertebral fracture
Identifiers
Local EPrints ID: 486398
URI: http://eprints.soton.ac.uk/id/eprint/486398
ISSN: 0937-941X
PURE UUID: 6eddaf10-ca5b-4e96-ab10-4791c3f0cf1f
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Date deposited: 19 Jan 2024 17:35
Last modified: 14 Aug 2024 01:35
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Author:
Michael Kriegbaum Skjødt
Author:
Joeri Nicolaes
Author:
Christopher Dyer Smith
Author:
Kim Rose Olsen
Author:
Cesar Libanati
Author:
Bo Abrahamsen
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