Chronic Pancreatitis and Fracture: A Retrospective, Population-Based Veterans Administration Study

Pancreas. 2016 Mar;45(3):355-61. doi: 10.1097/MPA.0000000000000381.

Abstract

Objectives: There is increasing evidence that chronic pancreatitis (CP) is a risk factor for osteoporotic fracture, but data on males with CP and fracture prevalence are sparse. We determined the association of sex and age using a large Veterans Administration database.

Methods: This was a retrospective analysis (1998-2007). Patients with CP (International Classification of Diseases code 577.1) and control subjects (without CP) were identified after exclusions and fracture prevalence (vertebral, hip, and wrist) were recorded.

Results: 453,912 Veterans Administration patients were identified (control subjects: 450,655 and patients with CP: 3257). Mean ages of control subjects and CP were 53.6 and 54.2 years (P < 0.014). Patients with CP had higher odds ratios of total fractures (2.35; 95% confidence interval [CI], 2.00-2.77), vertebral fracture 2.11 (95% CI, 1.44-3.01), hip fracture 3.49 (95% CI, 2.78-4.38), and wrist fracture 1.68 (95% CI, 1.29-2.18) when compared with control subjects. After adjusting for age group and etiology, patients with CP had increased odds of total fractures, vertebral fractures, and hip fractures (P < 0.05).

Conclusions: In this male-predominate Veterans Administration study, patients with CP were at increased risk of osteoporotic fractures. The risk was higher for hip fracture (>3 times) in patients with CP compared with control subjects. All patients with CP older than 45 years, irrespective of sex, should be screened for bone mineral density loss.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Chi-Square Distribution
  • Comorbidity
  • Female
  • Fractures, Bone / epidemiology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Osteoporotic Fractures / epidemiology
  • Pancreatitis, Chronic / epidemiology*
  • Population Surveillance / methods*
  • Prevalence
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Sex Factors
  • United States / epidemiology
  • United States Department of Veterans Affairs / statistics & numerical data*