TY - JOUR T1 - Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study JF - Canadian Medical Association Journal JO - CMAJ SP - 265 LP - 271 DO - 10.1503/cmaj.081720 VL - 181 IS - 5 AU - George Ioannidis AU - Alexandra Papaioannou AU - Wilma M. Hopman AU - Noori Akhtar-Danesh AU - Tassos Anastassiades AU - Laura Pickard AU - Courtney C. Kennedy AU - Jerilynn C. Prior AU - Wojciech P. Olszynski AU - Kenneth S. Davison AU - David Goltzman AU - Lehana Thabane AU - Amiran Gafni AU - Emmanuel A. Papadimitropoulos AU - Jacques P. Brown AU - Robert G. Josse AU - David A. Hanley AU - Jonathan D. Adachi Y1 - 2009/09/01 UR - http://www.cmaj.ca/content/181/5/265.abstract N2 - Background: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. Methods: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from across Canada participated in a 5-year observational cohort study. Incident fractures were identified on the basis of validated self-report and were classified by type (vertebral, pelvic, forearm or wrist, rib, hip and “other”). We subdivided fracture groups by the year in which the fracture occurred during follow-up; those occurring in the fourth and fifth years were grouped together. We examined the relation between the time of the incident fracture and death. Results: Compared with participants who had no fracture during follow-up, those who had a vertebral fracture in the second year were at increased risk of death (adjusted hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.1–6.6); also at risk were those who had a hip fracture during the first year (adjusted HR 3.2, 95% CI 1.4–7.4). Among women, the risk of death was increased for those with a vertebral fracture during the first year (adjusted HR 3.7, 95% CI 1.1–12.8) or the second year of follow-up (adjusted HR 3.2, 95% CI 1.2–8.1). The risk of death was also increased among women with hip fracture during the first year of follow-up (adjusted HR 3.0, 95% CI 1.0–8.7). Interpretation: Vertebral and hip fractures are associated with an increased risk of death. Interventions that reduce the incidence of these fractures need to be implemented to improve survival. ER -