Background and objectives: Reports on the mortality and its contributing factors after vertebral fracture (VFx) has been scarce, and limited to prevalent VFx. In this paper, we have studied the factors influencing mortality after freshly diagnosed VFx.
Methods and study design: 759 subjects aged 78.8±8.5 years old with back or lumbar pain, and diagnosed as fresh VFx by MRI were studied for their age, gender, number of prevalent fracture (s), survival or the date of death, circulating concentrations of Hb, albumin, C reactive protein, and estimated glomerular filtration rate (eGFR). Cox's proportional hazard analysis was performed to assess the significant predictors for mortality. The cut-off concentrations of the variables for mortality were analyzed using the receiver operator characteristic (ROC) curve.
Results: The median observation duration was 3.8 years, and 3-year survival rate was 78.8%. Cox's proportional hazard analysis has shown that serum albumin concentration (hazard ratio (HR) =0.355) and eGFR (HR=0.993) were significant predictors for mortality. The cut-off concentrations were 3.6 g/dL and 60 mL/min/1.73m2, respectively. Kaplan-Meier curves revealed that survival rates were significantly decreased in patients with both serum albumin concentration and eGFR below these cut-off concentrations.
Conclusions: The present study has revealed that malnutrition and impaired renal function were significant predictors for mortality after VFx.
背景与目的：关于椎体骨折（VFx）的报道仅限于患病率，而死亡率和影响因 素的报道却很少。本文研究了新诊断的VFx 死亡率的影响因素。方法和研究 设计：本研究纳入背或腰椎疼痛，经MRI 新诊断为VFx 的759 名患者（平均 年龄为78.8±8.5 岁）。记录了他们的年龄、性别、骨折发生的次数、生存或死 亡的日期、循环血红蛋白的浓度、白蛋白、C 反应蛋白和估计的肾小球滤过率 （eGFR）。进行Cox 比例风险分析，以评估死亡率有意义的预测指标。使用 受试者工作特征曲线（ROC）分析死亡率预测指标的截点值。结果：中位观 察时间为3.8 年，3 年生存率为78.8%。Cox 比例风险分析表明血清白蛋白 （危险比HR=0.355）浓度和eGFR（HR=0.993）是死亡率的重要预测指标， 截点值分别为3.6 g/dL 和60 mL/min/1.73m2。Kaplan-Meier 曲线显示，血清白 蛋白浓度和eGFR 都低于截点值的患者生存率显著降低。结论：目前的研究表 明，营养不良和肾功能受损是VFx 后死亡率的重要预测指标。.