Abstract
Evaluation of: Kado DM, Lui L-Y, Ensrud KE, Fink HA, Karlamangla AS, Cummings SR: Study of Osteoporotic Fractures: hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Ann. Intern. Med. 150, 681–687 (2009). Vertebral fractures, the most common type of osteoporotic fracture, are associated with an increase in morbidity and mortality. Previous studies have demonstrated that patients with vertebral fractures have an increased risk of death owing to pulmonary causes, suggesting that impaired pulmonary function due to excessive kyphotic curvature of the thoracic spine is the underlying etiological factor. However, since most patients with hyperkyphosis do not have vertebral fractures, it has not been clear whether hyperkyphosis caused by other disorders, such as degenerative disc disease, also predicts mortality. This study prospectively examined mortality rates in a subset of 610 women aged 67–93 years from the Study of Osteoporotic Fractures. These women, 95 of whom had prevalent vertebral fractures, were followed for an average of 13.5 years. It was found that hyperkyphosis only predicted increased mortality in the women with prevalent vertebral fractures, independent of age, self-reported health, lumbar spine bone mineral density, and number and severity of vertebral fractures. Hyperkyphosis is an important clinical marker for frailty and an ominous prognostic indicator for patients with vertebral fractures.
Financial & competing interests disclosure
The author has received grant/research support from Merck, Eli Lilly, Novartis, sanofi aventis, Amgen, Pfizer, Wyeth, Roche, GSK, Procter & Gamble; served as a consultant, advisory board member, speakers’ bureau participant, or given presentations at sponsored speaking events for Merck, Eli Lilly, Novartis, Procter & Gamble, sanofi aventis, Roche, GSK, Wyeth, Amgen, Upsher-Smith; and is a direct stock shareholder of General Electric and Procter & Gamble.
The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.