Mortality associated with vertebral deformity in men and women: Results from the European Prospective Osteoporosis Study (EPOS)

Clinically apparent vertebral deformities are associated with reduced survi val. The majority of subjects with radiographic vertebral deformity do not, however, come to medical attention. The aim of this study was to determine the association between radiographic vertebral deformity and subsequent mo rtality. The subjects who took part in the analysis were recruited for part icipation in a multicentre population-based survey of vertebral osteoporosi s in Europe. Men and women aged 50 years and over were invited to attend fo r an interviewer-administered questionnaire and lateral spinal radiographs. Radiographs were evaluated morphometrically and vertebral deformity define d according to established criteria. The participants have been followed by annual postal questionnaire - the European Prospective Osteoporosis Study (EPOS), Information concerning the vital status of participants was availab le from 6480 subjects, aged 50-79 years, from 14 of the participating centr es. One hundred and eighty-nine deaths (56 women and 133 men) occurred duri ng a total of 14380 person-years of follow-up (median 2.3 years). In women, after age adjustment, there was a modest excess mortality in those with, c ompared with those without, vertebral deformity: rate ratio (RR) = 1.9 (95% confidence interval (CI) 1.0,3.4). In men, the excess risk was smaller and non-significant RR = 1.3 (95% CI 0.9,2.0). After further adjusting for smo king, alcohol consumption, previous hip fracture, general health, body mass index and steroid use, the excess risk was reduced and non-significant in both sexes: women, RR = 1.6 (95% CI 0.9,3.0); men RR = 1.2 (95% CI 0.7,1.8) . Radiographic vertebral deformity is associated with a modest excess morta lity, particularly in women. Part of this excess can be explained by an ass ociation with other adverse health and lifestyle factors linked to mortalit y.