Fracture Mortality: Associations With Epidemiology and Osteoporosis Treatment

Nat Rev Endocrinol. 2014 Oct;10(10):592-602. doi: 10.1038/nrendo.2014.125. Epub 2014 Aug 5.


The rates of incident osteoporotic fractures seem to be stabilizing; however, fragility fractures are still associated with considerable disability, costs and an increased risk of mortality, which is particularly the case for fractures of the hip and vertebra. Mortality is usually highest during the first year after fracture; however, a notably increased mortality risk might persist for several years after the event. In addition to its efficacy in the prevention of new and recurrent osteoporotic fractures, medical treatment has been associated with improved survival after osteoporotic fractures. Observational studies and randomized controlled clinical trials have reported increased survival in patients with a fracture who are treated with bisphosphonates. Rates of medical treatment in patients with osteoporosis remain low, and although the rationale for the putative increase in survival is unclear, this emerging evidence might help further justify the use of medical treatment after fracture. However, further work is needed before medical therapy for mortality prevention in patients with osteoporotic fractures is accepted.

Publication types

  • Review

MeSH terms

  • Animals
  • Bone Density Conservation Agents / therapeutic use*
  • Diphosphonates / therapeutic use
  • Fractures, Bone / diagnosis
  • Fractures, Bone / drug therapy*
  • Fractures, Bone / mortality*
  • Hip Fractures / diagnosis
  • Hip Fractures / drug therapy
  • Hip Fractures / mortality
  • Humans
  • Osteoporosis / diagnosis
  • Osteoporosis / drug therapy*
  • Osteoporosis / mortality*
  • Randomized Controlled Trials as Topic / methods


  • Bone Density Conservation Agents
  • Diphosphonates