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Archives of Osteoporosis

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01-12-2017 | Original Article

Mortality following benign sacral insufficiency fracture and associated risk factors

Authors: Jae-Woo Park, Sang-Min Park, Hui Jong Lee, Choon-Ki Lee, Bong-Soon Chang, Hyoungmin Kim

Published in: Archives of Osteoporosis | Issue 1/2017

Abstract

Summary

This study demonstrated increased mortality following sacral insufficiency fractures as with other major osteoporotic fractures. The 6-month mortality rate was 9.8%, the 1-year mortality rate was 17.5%, and the 3-year mortality rate was 25.5%. Sex- and age-adjusted standardized mortality ratio increased after fractures.

Introduction

There are no data about mortality after sacral insufficiency fractures. The purposes of this study were to investigate the mortality rate among sacral insufficiency fracture patients and to identify risk factors associated with mortality.

Methods

This is a retrospective cohort study of patients diagnosed with sacral insufficiency fracture via radiological exam in a single institute from 2001 to 2014, excluding patients with pathological sacral fracture due to metastasis or primary tumor. Mortality and its predisposing factors were analyzed based on a review of electronic medical records and mortality data provided by the Korean Statistical Information Service. Kaplan–Meier survival analysis and Cox regression analysis were used for statistical analysis.

Results

A total of 325 patients were included (275 women and 50 men). The mean age at the time of diagnosis was 69.4 years. One hundred and forty patients (43.1%) had a history of malignancy, and 71 patients (21.8%) had undergone pelvic radiation therapy before fracture diagnosis. Twenty-one patients (6.5%) underwent sacroplasty, and the others underwent conservative management after fracture diagnosis. The mean follow-up was 51.5 months, and a total of 101 patients died at the final follow-up. The 6-month mortality rate was 9.8%, the 1-year mortality rate was 17.5%, and the 3-year mortality rate was 25.5%. Sex- and age-adjusted standardized mortality ratio (SMR) increased after fractures. The overall SMR is 8.9 at 3 months decreasing to 4.5 at 2 years. Multivariable Cox regression analysis showed that significant factors associated with increased mortality were male gender, malignancy history, lumbosacral fusion with distal fusion level S1, stroke history, low total femur bone mineral density score, and low body mass index.

Conclusions

Like other types of osteoporotic fractures, sacral insufficiency fractures are associated with increased mortality.

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Title: Mortality following benign sacral insufficiency fracture and associated risk factors
Authors: Jae-Woo Park
Sang-Min Park
Hui Jong Lee
Choon-Ki Lee
Bong-Soon Chang
Hyoungmin Kim
Publication date: 01-12-2017
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0395-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mortality following benign sacral insufficiency fracture and associated risk factors

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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