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

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

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.

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

MeSH terms

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