Clinical vertebral fracture increases risk for cardiopulmonary diseases

Takeaway

• Clinical vertebral fractures (CVFs) are associated with increases in subsequent risk of arotic dissection (AD), congestive heart failure (CHF), pneumonia, and acute respiratory distress syndrome (ARDS), according to a nationwide cohort from Taiwan.

Why this matters

• This is the first longitudinal cohort to analyse the association between CVF and cardiopulmonary diseases.

Study design

• Retrospective cohort of patients aged ≥18 years with a diagnosis of CVF (n=108,935) or no-CVF (n=108,935) matched on age, sex, index year, and comorbidities in the Taiwan National Health Insurance Research Database.
• Both groups were followed for 1 year of the incidence of cardiopulmonary diseases.
• Funding: Taiwan Ministry of Health; others.

Key results

• CVFs were associated with:
  • 23% increase in AD (4.85 vs 3.99 per 10,000 person-years in the CVF group vs no-CVF group, respectively; the adjusted HR was 1.23; 95% CI, 1.03-1.45).
  • 35% increase in CHF (119.1 vs 89.6 per 10,000 person-years; the adjusted HR was 1.35; 95% CI, 1.30-1.40).
  • 57% increase in pneumonia (283.3 vs 183.5 per 10,000 person-years; the adjusted HR was 1.57; 95% CI, 1.54-1.61).
  • 2-fold increase in ARDS (9.18 vs 4.18 per 10,000 person-years; the adjusted HR was 2.21; 95% CI, 1.91-2.57).

Limitations

• Retrospective observational design.
• Findings may not generalise to non-Asians.