Κυριακή 18 Σεπτεμβρίου 2022

Vertebral fractures assessed by dual-energy X-ray absorptiometry and all-cause mortality. The Tromsø Study 2007-2020

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Abstract
Vertebral fractures have been associated with increased mortality, but findings are inconclusive, and many vertebral fractures avoid clinical attention. We investigated this association in a general population of 2476 older adults aged ≥55 years from Tromsø, Norway, who were followed over 2007-2020, using dual-energy X-ray absorptiometry (DXA) at baseline to evaluate vertebral fractures (mild, moderate, severe). We used multiple Cox regression models to estimate hazard ratios (HRs) for all-cause mortality, adjusted for age, sex, body mass index, education, smoking, alcohol intake, cardiovascular disease and respiratory disease. Mean follow-up in the cohort was 11.2±2.7 years. 341 participants (13.8%) had one or more vertebral fractures at baseline, and 636 participants (25.7%) died between baseline and follow-up. Fully adjusted models showed a non-significant association between vertebral fracture status (yes/no) and mortality. Participants with ≥three vertebral fractures (HR 2.43, 95% CI 1.57-3.78), or at least one severe vertebral fracture (HR 1.65, 95% CI 1.26-2.15) had increased mortality compared to those with no vertebral fractures. DXA-based screening could be a potent and feasible tool in detecting vertebral fractures that are often clinically silent yet independently associated with premature death. Our data indicate that detailed vertebral assessment could be warranted for a more accurate survival estimation.
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