title: Characteristics of Prevalent Vertebral Fractures Predict New Fractures in Elderly Men.
abstract: BACKGROUND
  Studies have shown that specific characteristics of prevalent vertebral fractures are associated with a markedly low bone mineral density. This study evaluates if these characteristics also predict subsequent fractures.
  
  
  METHODS
  MrOS (Mister Osteoporosis) Sweden is a population-based, prospective observational study that includes 3014 community-living men who are sixty-nine to eighty-one years of age. At baseline, 1453 men underwent lateral thoracic and lumbar spine radiography; radiographs of 1427 men were readable. A radiologist identified and characterized prevalent vertebral fractures. Incident fractures during the next five and ten years were objectively registered with use of radiographs. The annual fracture incidence and relative risk of sustaining new fractures were assessed for men with and without baseline prevalent vertebral fracture. Data are presented as the mean and the 95% confidence interval.
  
  
  RESULTS
  There were 215 men (15.1%) with at least one prevalent vertebral fracture. During the five-year follow-up, these men had a relative risk of 3.3 (95% confidence interval, 2.6 to 4.3) of sustaining new fractures. The relative risk of sustaining any fracture was especially high in men with two or more prevalent vertebral fractures at 5.5 (95% confidence interval, 3.7 to 7.8), in men with different types of prevalent vertebral fractures at 5.7 (95% confidence interval, 3.6 to 8.5), in men with prevalent fractures in both the thoracic and lumbar regions at 6.4 (95% confidence interval, 4.5 to 8.8), and in men with prevalent fractures with a degree of vertebral body compression in the three worst quartiles, with the relative risk for the worst quartile at 4.0 (95% confidence interval, 2.6 to 5.9).
  
  
  CONCLUSIONS
  Older men with a prevalent vertebral fracture have three times increased risk of sustaining new fractures compared with men without a vertebral fracture. Older men with two or more prevalent vertebral fractures, different types of fractures (wedge, biconcave, and/or crush), fractures in both the thoracic and lumbar regions, and a degree of vertebral body compression in the three worst quartiles are at an especially high risk of sustaining new fractures. Older men with prevalent vertebral fractures should be considered for fracture-prevention efforts.
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Mehrsa
authors.initials: M
authors.lastname: Kherad
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Ralph
authors.initials: R
authors.lastname: Hasserius
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Jan-Åke
authors.initials: JÅ
authors.lastname: Nilsson
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Inga
authors.initials: I
authors.lastname: Redlund-Johnell
authors.affiliation: Center for Bone and Arthritis Research, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
authors.affiliation: Geriatric Medicine, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Lorentzon
authors.affiliation: Geriatric Medicine, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Mellström
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Clinical and Molecular Osteoporosis Research Unit, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Björn E
authors.initials: BE
authors.lastname: Rosengren
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*