Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women
Publication: Annals of Internal Medicine
Volume 150, Number 10
Abstract
Background:
Excessive kyphosis may be associated with earlier mortality, but previous studies have not controlled for clinically silent vertebral fractures, which are a known mortality risk factor.
Objective:
To determine whether hyperkyphosis predicts increased mortality independent of vertebral fractures.
Design:
Prospective cohort study.
Setting:
Four clinical centers in Baltimore County, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania.
Patients:
610 women, age 67 to 93 years, from a cohort of 9704 women recruited from community-based listings between 1986 and 1988.
Measurements:
Kyphosis was measured by using a flexicurve. Prevalent radiographic vertebral fractures at baseline were defined by morphometry, and mortality was assessed during an average follow-up of 13.5 years.
Results:
In age-adjusted models, each SD increase in kyphosis carried a 1.14-fold increased risk for death (95% CI, 1.02 to 1.27; P = 0.023). After adjustment for age and other predictors of mortality, including such osteoporosis-related factors as low bone density, moderate and severe prevalent vertebral fractures, and number of prevalent vertebral fractures, women with greater kyphosis were at increased risk for earlier death (relative hazard per SD increase, 1.15 [CI, 1.01 to 1.30]; P = 0.029). On stratification by prevalent vertebral fracture status, only women with prevalent fractures were at increased mortality risk from hyperkyphosis, independent of age, self-reported health, smoking, spine bone mineral density, number of vertebral fractures, and severe vertebral fractures (relative hazard per SD increase, 1.58 [CI, 1.06 to 2.35]; P = 0.024).
Limitation:
The study population included only white women.
Conclusion:
In older women with vertebral fractures, hyperkyphosis predicts an increased risk for death, independent of underlying spinal osteoporosis and the extent and severity of vertebral fractures.
Primary Funding Source:
National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute on Aging.
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Information & Authors
Information
Published In
Annals of Internal Medicine
Volume 150 • Number 10 • 19 May 2009
Pages: 681 - 687
History
Published online: 19 May 2009
Published in issue: 19 May 2009
Keywords
- Cardiology and cardiovascular diseases
- Death rates
- Diagnostic imaging
- Diagnostic medicine
- Diagnostic techniques
- Epidemiology
- Imaging techniques
- Medical risk factors
- Mortality
- Musculoskeletal system
- Orthopedics
- Population statistics
- Prevention, policy, and public health
- Research and reporting methods
- Research design
- Rheumatology
- Skeleton
- Spine
- Stroke
- Surgery
- Vascular diseases
- Vascular medicine
- Vital statistics
Copyright
© 2009 American College of Physicians.
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Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women. Ann Intern Med.2009;150:681-687. [Epub 19 May 2009]. doi:10.7326/0003-4819-150-10-200905190-00005
Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women. Ann Intern Med.2009;150:681-687. [Epub 19 May 2009]. doi:10.7326/0003-4819-150-10-200905190-00005
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