title: Prevalence of thoracic vertebral fractures in hospitalized elderly patients with heart failure.
abstract: OBJECTIVE
  Heart failure (HF) has been associated with increased risk of fragility fractures. Indeed, most literature data on fractures were based on an historical and clinical approach focused on the identification of peripheral fractures, whereas the risk of vertebral fractures in this clinical setting is still unclear.
  
  
  METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  To evaluate the prevalence and determinants of radiological thoracic vertebral fractures in patients with HF.
  
  
  METHODS
  The study includes 1031 elderly hospitalized patients (491 females and 540 males; median age, 75 years; range, 65-90; 430 patients with HF) who were evaluated for the presence of thoracic vertebral fractures by quantitative morphometric analysis, using chest X-ray routinely performed in the diagnostic work-up of HF.
  
  
  RESULTS
  Vertebral fractures were found in 166 patients (16.1%), the prevalence being significantly higher in patients with HF as compared with those without HF, both in females (30.9 vs 15.8%; P<0.001) and in males (16.4 vs 7.4%; P=0.001). The association between HF and vertebral fractures remained statistically significant (odds ratio, 2.14; 95% CI, 1.25-3.66; P=0.01) even after adjustment for age, sex, loop diuretic therapy, anticoagulant therapy, proton pump therapy, coexistent chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, and chronic liver diseases. In patients with HF, vertebral fractures were positively correlated with female sex, duration of HF, ischemic heart disease, cigarette smoking, and treatment with anti-osteoporotic drugs, and inversely correlated with left ventricular ejection fraction.
  
  
  CONCLUSIONS
  Hospitalized patients suffering from HF are at higher risk of vertebral fractures than patients without HF in the same clinical context.
authors.affiliation: Endocrinology, University of Brescia, Brescia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mazziotti
authors.forename: M
authors.initials: M
authors.lastname: Baracca
authors.forename: M
authors.initials: M
authors.lastname: Doga
authors.forename: T
authors.initials: T
authors.lastname: Porcelli
authors.forename: P P
authors.initials: PP
authors.lastname: Vescovi
authors.forename: A
authors.initials: A
authors.lastname: Giustina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*