Proportions of fall-related and insufficiency-related vertebral fractures among hospitalized older patients.

UNLABELLED: This study determined the proportions of fall-related and insufficiency-related vertebral fractures among 325 older hospitalized patients. The fracture etiology was determined by a comprehensive interview focusing on the circumstances at the onset of fracture-related pain. Falls were a markedly more frequent cause of vertebral fractures than insufficiency.

PURPOSE: The majority of vertebral fractures in older adults occur either as insufficiency fracture or as a consequence of a fall. The objective of this study was to determine the proportions of fall-related and insufficiency-related fractures among patients hospitalized with clinically symptomatic vertebral fractures.

METHODS

This cross-sectional study included 325 hospitalized patients aged ≥ 65 years with vertebral fractures from three hospitals. The fracture etiology (fall-related vs. insufficiency-related) was determined using a comprehensive clinical interview that focused on the circumstances surrounding the initial onset of fracture-related pain. The proportion of these two etiologies was analyzed for all fractures, across different fracture locations, and within various strata of personal and functional parameters.

RESULTS

The mean age was 83 ± 6 years and 73% of patients were female. Among all vertebral fractures, 60.9% were classified as fall-related, 30.8% as insufficiency-related, and in 8.3% the exact etiology remained uncertain. Falls accounted for the majority of cervical vertebral fractures (88.2%) and were less common as an etiology in thoracic (54.8%) and lumbar (59.5%) fractures. A higher proportion of insufficiency fractures was observed in underweight patients (42.1%) compared to normal weight (24.6%) or overweight patients (28.9%). No statistically significant differences in vertebral fracture etiology were observed across strata of sex, vertebral fracture classification, care need, risk of a major osteoporotic fracture, or life-space mobility.

CONCLUSION

The findings show that falls are a markedly more frequent cause of vertebral fractures than insufficiency-related fractures. This pattern is consistent across the overall study population and the strata of various variables.