title: Contribution of hypoalbuminemia and decreased renal function to the increased mortality after newly diagnosed vertebral fracture in Japanese subjects.
abstract: OBJECTIVE
  Reports on the mortality and its contributing factors after vertebral fracture (VFx) has been scarce, and limited to prevalent VFx. In this paper, we have studied the factors influencing mortality after freshly diagnosed VFx.
  
  
  METHODS
  759 subjects aged 78.8±8.5 years old with back or lumbar pain, and diagnosed as fresh VFx by MRI were studied for their age, gender, number of prevalent fracture (s), survival or the date of death, circulating concentrations of Hb, albumin, C reactive protein, and estimated glomerular filtration rate (eGFR). Cox's proportional hazard analysis was performed to assess the significant predictors for mortality. The cut-off concentrations of the variables for mortality were analyzed using the receiver operator characteristic (ROC) curve.
  
  
  RESULTS
  The median observation duration was 3.8 years, and 3-year survival rate was 78.8%. Cox's proportional hazard analysis has shown that serum albumin concentration (hazard ratio (HR) =0.355) and eGFR (HR=0.993) were significant predictors for mortality. The cut-off concentrations were 3.6 g/dL and 60 mL/min/1.73m2, respectively. Kaplan-Meier curves revealed that survival rates were significantly decreased in patients with both serum albumin concentration and eGFR below these cut-off concentrations.
  
  
  CONCLUSIONS
  The present study has revealed that malnutrition and impaired renal function were significant predictors for mortality after VFx.
authors.affiliation: Department of Orthopaedic Surgery, Tamana Central Hospital, Tamana, Kumamoto, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Health and Nutrition, Osaka Shoin Women's University, Higashi-osaka, Osaka, Japan. Email: kuwabara.akiko@osaka-shoin.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuwabara
authors.affiliation: Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mizuta
authors.affiliation: Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications*; D007564:Japan; D007668:Kidney / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D044342:Malnutrition / Q000150:complications*; D016016:Proportional Hazards Models; D012709:Serum Albumin / Q000032:analysis; D016103:Spinal Fractures / Q000150:complications / Q000401:mortality* / Q000473:pathology
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein