Prevalence and burden of vertebral fractures in older men and women with hip fracture: A cross-sectional study.

Objective: To investigate the prevalence and burden (combination of number and severity) of vertebral fractures in men and women with hip fracture.

Methods: We investigated 458 of 490 hip-fracture patients admitted consecutively to a rehabilitation hospital. Lateral radiographs of the spine were taken 19.2 ± 5.5 days (mean ± SD) after hip-fracture occurrence. To obtain a summary measure of vertebral fracture burden, we calculated the spinal deformity index (SDI) by summing the fracture grades assessed using Genant's method of all vertebrae (T4 to L4).

Results: The median SDI score was 2 in both the 411 women and the 47 men (interquartile range 0-4 in both groups), and no significant between-sex differences were found (P = 0.52). A total of 69% of the women (95% CI 65-74%), and 60% of the men (95% CI 45-74%) had at least one mild vertebral fracture (SDI score ≥1), 41% of the women (95% CI 36-46%) and 38% of the men (95% CI 24-53%) had a SDI score ≥3, whereas 16% of the women (95% CI 12% 19%) and 17% of the men (95%CI 6-28%) had at least one severe vertebral fracture. Sex was not significantly associated with a SDI score ≥1, or ≥3 or with the presence of at least one severe vertebral fracture after adjustment for age, hip-fracture type, cognitive impairment, pressure ulcers, neurological impairment, comorbidities, number of medications in use and Barthel index scores.

Conclusions: The prevalence of vertebral fractures was high after hip fracture in both men and women. We found no significant between-sex differences in the prevalence and burden of vertebral fractures.