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Osteoporosis and Mortality
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
I would like to thank Dr. Galus for bringing up the important issue of increased mortality in patients with osteoporotic fractures. In an epidemiologic study based on the geographically defined population of Rochester, Minnesota, Cooper and associates [1] found a significant reduction in relative 5-year survival of about 20% in patients with hip and vertebral fracture but not patients with Colles fracture of the distal forearm. The patients with vertebral fracture showed a progressive increase in excess mortality over 5 years, whereas the excess mortality in patients with hip fracture occurred largely in the first 6 months after the fracture. Increased mortality has also been reported after pelvic fractures in older women [2]. Death after hip fracture in both men and women [2, 3] not only is associated with complications after surgery but is also influenced by comorbid conditions. The relation between osteoporosis and comorbid conditions is complex; for example, decreased bone density is associated with an increased risk for stroke [4] and a decreased risk for breast cancer [5]. An understanding of these complex interactions may help us understand the association between osteoporosis and death, but the fact remains that osteoporosis will rarely be recorded as the cause of death on a death certificate. Moreover, although we do not know whether treatment of osteoporosis will reduce this excess mortality, I believe that conscientious physicians like Dr. Galus, who identify and treat osteoporotic patients, will have an important impact on mortality as well as morbidity in our aging population.
Lawrence G. Raisz, MD
University of Connecticut Health Center; Farmington, CT 06030-1850
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
