Burden of major osteoporotic fractures ‘on the rise’
MedWire News: The burden of acute hospitalizations for major osteoporotic fractures (MOF) has increased in both women and men, and in women has become significantly greater than that for major cardiovascular events (MCE), the results of a Swiss study indicate.
MOF, which includes fractures of the hip, spine, distal forearm, and proximal humerus, are one of the leading causes of morbidity, mortality and hospitalization, say the researchers.
To investigate further, Kurt Lippuner (University of Bern) and colleagues examined data from the Swiss Federal Statistical Office to compare the trends in the number, age-standardized incidence, mean length of stay (LoS), and cost of hospitalized MOF and MCE, including acute myocardial infarction (MI), stroke, and heart failure, in women and men aged 45 years or older, between 2000 and 2008.
The results, published in the journal Osteoporosis International, show that the incidence of acute hospitalizations increased by 3.4% and 0.3% in women and men, respectively, over the study period. There was a significant 15.0% and 11.0% respective decrease in hip fractures in women and men, but this was offset by a significant increase in nonhip fractures of 14.8% and 13.8%, respectively.
Over the same period, the incidence of acute hospitalizations for MCE increased by 4.4% in women and 8.2%, in men, which comprised significant increases in hospitalizations for MI and heart failure, and a significant reduction in the incidence of stroke. The team also notes that there was a significant decrease in hospitalizations for chronic obstructive pulmonary disease (COPD).
While there was an almost linear reduction in the mean LoS for all indications and in both genders during the study period, hospitalization for MOF was responsible for three times more hospitalization days than COPD and breast cancer, and 1.5 times more days in hospital than MCE in women.
The team also found that inpatient costs for women and men increased significantly for MOF and for MCE, by 30.1% and 42.7% and 22.6% and 47.1%, respectively. In women, the costs for MOF were significantly higher than for MCE, and the gap widened over the study period.
"In the present analysis, we report an increasing incidence of both MOF and major cardiovascular diseases between 2000 and 2008 in Switzerland, which is consistent with a possible association between both disease entities," the researchers write.
"We also report decreasing trends in hip fractures and stroke and increasing trends in nonhip fractures and acute MIs, which raises the question whether the supposed association between osteoporosis and cardiovascular diseases might be more multifaceted than suggested to date."
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By Liam Davenport