Citation

van der Jagt-Willems HC, van Hengel M, Vis M, van Munster BC, van Campen JP, Tulner LR, Lems WF. Age Ageing 2012; 41(2): 200-206.

Affiliation

Department of Geriatrics, Slotervaart Hospital, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.

Copyright

(Copyright © 2012, Oxford University Press)

DOI

10.1093/ageing/afr174

PMID

22217460

Abstract

OBJECTIVES: to determine the prevalence of vertebral fractures and their risk factors in geriatric patients. DESIGN: prospective cohort study.Setting: teaching hospital in Amsterdam, The Netherlands. SUBJECTS: three hundred and three geriatric patients, who had their first visit at a diagnostic day hospital between April and August 2007. MEASUREMENTS: lateral X-rays of the lumbar spine and chest were performed; vertebral fractures were scored according to the semi-quantitative method of Genant by trained observers and compared with the official report of radiologists. Co-morbidity, reported falls, mobility and cognitive function were scored. RESULTS: vertebral fractures were observed in 51% (156/303) of geriatric patients. Sixty-nine per cent (107/156) of these fractures were moderate to severe. In 21% (33/156) of the patients with a fracture, vertebral fractures were diagnosed on the lumbar spine X-ray alone. Patients with vertebral fractures had more previous non-vertebral fractures (odds ratio: 2.40 95% CI: 1.40-4.10), had lower serum albumin levels (OR: 0.92 95% CI: 0.87-0.97) and more current prednisone use (OR: 8.94 95% CI: 1.12-71.45). Co-morbidity and cognitive decline were not identified as risk factors. Radiologists reported vertebral fractures in 53% (82/156) of the cases. CONCLUSION: this study showed a very high prevalence of vertebral fractures in geriatric patients; particularly the high prevalence of moderate and severe fractures is remarkable. Because of this high prevalence, the routinely performed lateral X-ray of the chest should be used to look for vertebral fractures. An additional X-ray of the lumbar spine might be useful in patients without vertebral fractures on the chest X-ray.

Language: en