Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a long
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ORIGINAL ARTICLE
Blindness increases the risk for hip fracture and vertebral fracture but not the risk for distal radius fracture: a longitudinal follow-up study using a national sample cohort H.G. Choi 1,2 & J.K. Lee 3
&
M.J. Lee 4 & B. Park 1 & S. Sim 5 & S.-M. Lee 6
Received: 25 November 2019 / Accepted: 21 May 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary The risks for hip fracture and vertebral fracture, but not the risk for distal radius fracture, were significantly higher in the blindness group than in the control group with a maximum 12-year follow-up. Purpose To evaluate the influence of visual impairment on the risk for osteoporotic fractures at common sites: hip, thoracic/ lumbar vertebra, and distal radius. Methods This longitudinal follow-up study used a database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,125,691 subjects, 3918 patients with visual impairment and age ≥ 50 years were enrolled in a 1:4 ratio; 15,672 control participants were matched for age, sex, income, and region of residence. Stratified Cox proportional-hazards models were used to evaluate the crude and adjusted (for steroid medication, rheumatoid arthritis, depression, osteoporosis, diabetes mellitus, and stroke history) hazard ratios (HRs) for each fracture site. Fracture diagnoses were based on the ICD10 codes: hip fracture (S720, S721, S722), vertebral fracture (S220, S320), and distal radius fracture (S525). Results The HRs for hip and vertebral fracture were significantly higher in the blindness group (adjusted HR = 2.46, p < 0.001 for hip fracture; adjusted HR = 1.42, p = 0.020 for thoracic/lumbar vertebral fracture) than in the matched control group. However, the HR for distal radius fracture was not higher in the blindness group. The HRs for all three fracture sites were not significantly higher in the non-blindness visual impairment group after adjustment. Conclusion The risks for hip fracture and vertebral fracture were significantly higher in the blindness group. However, the risk for distal radius fracture was not related to visual impairment including blindness. Keywords Epidemiology . Forearm fracture . Hip fracture . Osteoporosis . Vertebral fracture . Visual impairment
Dr. Sim is responsible for the design of the statistical analysis and that Dr. Lee is responsible for the clinical interpretation and preparation of the manuscript Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-020-05475-0) contains supplementary material, which is available to authorized users. * S. Sim [email protected] * S.-M. Lee [email protected] 1
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
2
Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
3
Department of Orthopaedic Surgery, Konkuk University Medical Center, Research Institut
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