Incidence and Mortality of Vertebral Compression Fracture Among All Age Groups: A Nationwide, Population-based Study in the Republic of Korea

Background: Although several studies have examined the epidemiological features of vertebral compression fractures (VCF) among elderly patients, few studies have reported the epidemiology of VCF among younger individuals.Objective: To examine trends in the incidence and mortality of VCF in both the old (>= 65 years) and young (< 65 years) age groups. This study aimed to investigate the incidence and mortality of VCF among all age groups in Korea.Study Design: Population-based cohort study.Setting: A nationwide, population-based setting.Methods: Using the Korean National Health Insurance database, which has complete population coverage, we identified patients diagnosed with VCF between 2005 to 2018. Differences in incidence, survival and mortality were compared across groups using Kaplan-Meier analysis and Cox regression for all age groups and both genders.Results: We identified a total of 742,993 VCF patients and the annual incidence was 140.09/100,000 individuals. Although the incidence of VCF was significantly higher in the older age compared to younger age group (556.38/100,000 vs. 44.09/100,000 individuals), the mortality rate ratio for VCF patients was higher among younger compared to older individuals (old: 1.59 vs. young: 2.87). In our multivariable-adjusted analysis, the hazard ratio for multiple fractures, traumatic injury and osteoporosis were higher in patients aged < 65 years compared to patients aged >= 65 years, suggesting that the impact of these clinical variables on mortality is more significant in the younger age group.Limitation: A limitation of this study was its lack of information on clinical features, such as disease severity and laboratory data. The precise cause of death of VCF patients could not be confirmed from the study database.Conclusions: The mortality rate ratio and hazard ratio were significantly higher among younger patients with VCF, indicating the need for further research on VCF in younger age groups.