Yonsei Med J.  2018 Mar;59(2):317-324. 10.3349/ymj.2018.59.2.317.

Prevalence of Frailty in Patients with Osteoporotic Vertebral Compression Fracture and Its Association with Numbers of Fractures

Affiliations
  • 1Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. highcervical@gmail.com
  • 2Division of Sports Science, Korea Institute of Sports Science, Seoul, Korea.
  • 3Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract

PURPOSE
To assess the association between frailty and osteoporotic vertebral compression fracture (OVCF) and to evaluate the relationship between numbers of OVCFs and frailty.
MATERIALS AND METHODS
We enrolled 760 subjects, including 59 patients (with OVCF) and 701 controls (without OVCF). Successful matching provided 56 patient-control pairs. We analyzed principal clinical and demographic information, which included sex, age, height, weight, body mass index (BMI), variable frailty phenotypes, and Oswestry Disability Index (ODI) and EuroQol 5-dimension questionnaire (EQ-5D) scores. The association between frailty and OVCF was ascertained. In addition, the degrees of disability and quality of life attributable to frailty were determined.
RESULTS
The prevalence of frailty was significantly higher in the OVCF group than in the control group (p < 0.001). Most of the frailty phenotypes, such as exhaustion, physical inactivity, slowness, and handgrip strength, were also significantly observed in the OVCF group. Within the OVCF group, the participants with frailty had significantly higher disability and lower quality of life than those in a robust state (p < 0.001 for ODI and EQ-5D). In addition, the multivariate logistic regression analysis demonstrated that the patients with low BMI [odds ratio (OR)=0.704; 95% confidence interval (CI), 0.543-0.913] and ≥3 fractures (OR=9.213; 95% CI, 1.529-55.501) within the OVCF group were associated with higher odds of frailty.
CONCLUSION
The present study showed significant relationships between frailty and OVCF, severity of symptoms, and disability induced by OVCF. Furthermore, frailty could be a causal and/or resulting factor of OVCFs.

Keyword

Frailty; osteoporotic vertebral compression fracture; Oswestry disability index; EuroQol 5-dimension questionnaire; Fried frailty criteria

MeSH Terms

Aged
Aged, 80 and over
Case-Control Studies
Female
Fractures, Compression/*complications/*epidemiology
Frailty/*complications/*epidemiology
Humans
Male
Middle Aged
Osteoporotic Fractures/*complications/etiology
Prevalence
Propensity Score
Quality of Life
Spinal Fractures/*complications/*epidemiology
Treatment Outcome

Figure

  • Fig. 1 Enrollment, group assignment, and propensity score matching. OVCF, osteoporotic vertebral compression fracture.


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