Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Using vital statistics to estimate the population-level impact of osteoporotic fractures on mortality based on death certificates, with an application to France (2000-2004)

Authors: Nelly Ziadé, Eric Jougla, Joël Coste

Published in: BMC Public Health | Issue 1/2009

Login to get access

Abstract

Background

We developed a methodology using vital statistics to estimate the impact of osteoporotic fractures on the mortality of an entire population, and applied it to France for the period 2000-2004.

Methods

Current definitions of osteoporotic fractures were reviewed and their components identified. We used the International Classification of Diseases with national vital statistics data for the French adult population and performed cross-classifications between various components: age, sex, I-code (site) and E-code (mechanism of fracture). This methodology allowed identification of appropriate thresholds and categorization for each pertinent component.

Results

2,625,743 death certificates were analyzed, 2.2% of which carried a mention of fracture. Hip fractures represented 55% of all deaths from fracture. Both sexes showed a similar pattern of mortality rates for all fracture sites, the rate increased with age from the age of 70 years. The E-high-energy code (present in 12% of death certificates with fractures) was found to be useful to rule-out non-osteoporotic fractures, and to correct the overestimation of mortality rates. Using this methodology, the crude number of deaths associated with fractures was estimated to be 57,753 and the number associated with osteoporotic fractures 46,849 (1.85% and 1.78% of all deaths, respectively).

Conclusion

Osteoporotic fractures have a significant impact on overall population mortality.
Appendix
Available only for authorised users
Literature
1.
Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, Nordin BE, Barrett-Connor E, Black D, Bonjour JP, et al: Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int. 1999, 10 (4): 259-264. 10.1007/s001980050224.CrossRefPubMed
2.
Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK: International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res. 2002, 17 (7): 1237-1244. 10.1359/jbmr.2002.17.7.1237.CrossRefPubMed
3.
Ray NF, Chan JK, Thamer M, Melton LJ: Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997, 12 (1): 24-35. 10.1359/jbmr.1997.12.1.24.CrossRefPubMed
4.
Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002, 359 (9319): 1761-1767. 10.1016/S0140-6736(02)08657-9.CrossRefPubMed
5.
Lofman O, Berglund K, Larsson L, Toss G: Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int. 2002, 13 (1): 18-25. 10.1007/s198-002-8333-x.CrossRefPubMed
6.
Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR: Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009, 301 (5): 513-521. 10.1001/jama.2009.50.CrossRefPubMed
7.
Wolinsky FD, Fitzgerald JF, Stump TE: The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study. Am J Public Health. 1997, 87 (3): 398-403. 10.2105/AJPH.87.3.398.CrossRefPubMedPubMedCentral
8.
Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA: Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999, 353 (9156): 878-882. 10.1016/S0140-6736(98)09075-8.CrossRefPubMed
9.
Ismail AA, Pye SR, Cockerill WC, Lunt M, Silman AJ, Reeve J, Banzer D, Benevolenskaya LI, Bhalla A, Bruges Armas J, et al: Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int. 2002, 13 (7): 565-571. 10.1007/s001980200074.CrossRefPubMed
10.
Kado DM, Duong T, Stone KL, Ensrud KE, Nevitt MC, Greendale GA, Cummings SR: Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int. 2003, 14 (7): 589-594. 10.1007/s00198-003-1412-5.CrossRefPubMed
11.
Hasserius R, Karlsson MK, Jonsson B, Redlund-Johnell I, Johnell O: Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly--a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int. 2005, 76 (4): 235-242. 10.1007/s00223-004-2222-2.CrossRefPubMed
12.
Vestergaard P, Rejnmark L, Mosekilde L: Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications. Osteoporos Int. 2007, 18 (12): 1583-1593. 10.1007/s00198-007-0403-3.CrossRefPubMed
13.
Ryg J, Rejnmark L, Overgaard S, Brixen K, Vestergaard P: Hip fracture patients at risk of second hip fracture: a nationwide population-based cohort study of 169,145 cases during 1977-2001. J Bone Miner Res. 2009, 24 (7): 1299-1307. 10.1359/jbmr.090207.CrossRefPubMed
14.
15.
Nashold RD, Naor EM: Alcohol-related deaths in Wisconsin: the impact of alcohol on mortality. Am J Public Health. 1981, 71 (11): 1237-1241. 10.2105/AJPH.71.11.1237.CrossRefPubMedPubMedCentral
16.
Armstrong D, Wing S, Tyroler HA: Race differences in estimates of sudden coronary heart disease mortality, 1980-1988: the impact of ill-defined death. J Clin Epidemiol. 1996, 49 (11): 1247-1251. 10.1016/S0895-4356(96)00217-X.CrossRefPubMed
17.
Anonymous: Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med. 1993, 94: 646-650. 10.1016/0002-9343(93)90218-E.CrossRef
18.
19.
Seeley DG, Browner WS, Nevitt MC, Genant HK, Scott JC, Cummings SR: Which fractures are associated with low appendicular bone mass in elderly women? The Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1991, 115 (11): 837-842.CrossRefPubMed
20.
Court-Brown CM, Caesar B: Epidemiology of adult fractures: A review. Injury. 2006, 37 (8): 691-697. 10.1016/j.injury.2006.04.130.CrossRefPubMed
21.
Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A: The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001, 12 (5): 417-27. 10.1007/s001980170112.CrossRefPubMed
22.
Mackey DC, Lui LY, Cawthon PM, Bauer DC, Nevitt MC, Cauley JA, Hillier TA, Lewis CE, Barrett-Connor E, Cummings SR: High-trauma fractures and low bone mineral density in older women and men. JAMA. 2007, 298 (20): 2381-2388. 10.1001/jama.298.20.2381.CrossRefPubMed
23.
Marshall D, Johnell O, Wedel H: Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1999, 312: 1254-1259.CrossRef
24.
Fulton JP: New guidelines for the prevention and treatment of osteoporosis. NOF. Med Health RI. 1999, 82: 110-124.
25.
Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, et al: Predictive value of BMD for hip and other fractures. J Bone Miner Res. 2005, 20 (7): 1185-1194. 10.1359/JBMR.050304.CrossRefPubMed
26.
Melton LJ, Thamer M, Ray NF, Chan JK, Chesnut CH, Einhorn TA, Johnston CC, Raisz LG, Silverman SL, Siris ES: Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997, 12 (1): 16-23. 10.1359/jbmr.1997.12.1.16.CrossRefPubMed
27.
Pavillon G, Laurent F: Certification et codification des causes médicales de décès. Bulletin Epidémiologique Hebdomadaire. 2003, 30/31: 134-138.
28.
29.
Jougla E, Pavillon G, Rossollin F, de Smedt M, Bonte J: Improvement of the quality and comparability of causes-of-death statistics inside the European Community. EUROSTAT Task Force on "causes of death statistics". Rev Epidemiol Sante Publique. 1998, 46 (6): 447-456.PubMed
30.
31.
Coste J, Jougla E: Mortality from rheumatoid arthritis in France, 1970-1990. Int J Epidemiol. 1994, 23 (3): 545-552. 10.1093/ije/23.3.545.CrossRefPubMed
32.
Jougla E, Papoz L, Balkau B, Simon D, Vauzelle-Kervroedan F, Hatton F: [Analysis of diabetes-related mortality in France (1970-1987) from multiple causes of death]. Diabete Metab. 1991, 17 (3): 337-345.PubMed
33.
Lavallee PC, Labreuche J, Spieler JF, Jougla E, Amarenco P: Stroke and Vascular Mortality Trends in France: 1979-2001. Neuroepidemiology. 2007, 29: 78-82. 10.1159/000109500.CrossRefPubMed
34.
Marcellin P, Pequignot F, Delarocque-Astagneau E, Zarski JP, Ganne N, Hillon P, et al: Mortality related to chronic hepatitis B and chronic hepatitis C in France: Evidence for the role of HIV coinfection and alcohol consumption. Journal of Hepatology. 2008, 48 (2): 200-7. 10.1016/j.jhep.2007.09.010.CrossRefPubMed
35.
Fuhrman C, Jougla E , Nicolau J, Eilstein D, Delmas MC: Deaths from chronic obstructive pulmonary disease in France, 1979-2002: a multiple cause analysis. Thorax. 2006, 61 (11): 930-4. 10.1136/thx.2006.061267.CrossRefPubMedPubMedCentral
36.
Lienhart A, Auroy Y, Péquignot F, Benhamou D, Warszawski J, Bovet M, Jougla E: Survey of Anesthesia-related Mortality in France. Anesthesiology. 2006, 105: 1087-1097. 10.1097/00000542-200612000-00008.CrossRefPubMed
37.
Rey G, Jougla E, Fouillet A, Pavillon G, Bessemoulin P, Frayssinet P, Clavel J, Hemon D: The impact of major heat waves on all-cause and cause-specific mortality in France from 1971 to 2003. Int Arch Occup Environ Health. 2007, 80: 615-626. 10.1007/s00420-007-0173-4.CrossRefPubMedPubMedCentral
38.
Cattell R: The scree test for the number of factors. Multivar Behav Res. 1966, 1: 245-276. 10.1207/s15327906mbr0102_10.CrossRef
39.
Ismail AA, O'Neill TW, Cooper C, Finn JD, Bhalla AK, Cannata JB, Delmas P, Falch JA, Felsch B, Hoszowski K, et al: Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int. 1998, 8 (3): 291-297. 10.1007/s001980050067.CrossRefPubMed
40.
Cummings SR: Bone biology, epidemiology and general principles. Osteoporosis. Edited by: Cummings SR, Cosman F, Jamal S. 2002, Philadelphia: ACP, 3-25.
41.
Hohlweg-Majert B, Schmelzeisen R, Pfeiffer BM, Schneider E: Significance of osteoporosis in craniomaxillofacial surgery: a review of the literature. Osteoporos Int. 2006, 17 (2): 167-179. 10.1007/s00198-005-1967-4.CrossRefPubMed
42.
Portier F, Salvan D, Duruisseau O, Herman P, Tran Ba Huy P: A rare clival and sellar fracture with pneumatocephalus. Auris Nasus Larynx. 2002, 29 (2): 195-198. 10.1016/S0385-8146(01)00139-0.CrossRefPubMed
43.
Werning JW, Downey NM, Brinker RA, Khuder SA, Davis WJ, Rubin AM, Elsamaloty HM: The impact of osteoporosis on patients with maxillofacial trauma. Arch Otolaryngol Head Neck Surg. 2004, 130 (3): 353-356. 10.1001/archotol.130.3.353.CrossRefPubMed
44.
Kansky A, Bozic M, Ihan Hren N: Mandibular osteoporotic fracture: A case report. J Am Geriatr Soc. 2006, 54 (12): 1956-1957. 10.1111/j.1532-5415.2006.00959.x.CrossRefPubMed
45.
Iida S, Reuther T, Kogo M, Matsuya T, Muhling J: [Retrospective analysis of facial fractures related to falls in 260 Japanese patients]. Mund Kiefer Gesichtschir. 2002, 6 (6): 421-426. 10.1007/s10006-002-0422-3.CrossRefPubMed
46.
NIH: Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001, 285: 785-795. 10.1001/jama.285.6.785.CrossRef
47.
48.
WHO: Report of a WHO Study Group. Geneva. World Health Organ Tech Rep Ser. 1994, 843: 1-129.
Metadata
Title
Using vital statistics to estimate the population-level impact of osteoporotic fractures on mortality based on death certificates, with an application to France (2000-2004)
Authors
Nelly Ziadé
Eric Jougla
Joël Coste
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-344

Other articles of this Issue 1/2009

BMC Public Health 1/2009 Go to the issue

Research article

Attitudes to kidney donation among primary care patients in rural Crete, Greece

Research article

"Who am I? Where am I?" Experiences of married young women in a slum in Islamabad, Pakistan

Research article

Timeliness of national notifiable diseases surveillance system in Korea: a cross-sectional study

Research article

Time series analysis of dengue fever and weather in Guangzhou, China

Research article

Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa

Research article

Assessing knowledge of human papillomavirus and collecting data on sexual behavior: computer assisted telephone versus face to face interviews