PP-144 : Dizziness increases the risk of fractures: A retrospective cohort study

Carsten Kruschinski, Odile Sheehy, Jacques Lelorier, Eva Hummers-Pradier, Germany
Dizziness is known to be associated with the risk of falls. However, there is not much direct evidence for the increase of fractures caused by dizziness. Do patients suffering from dizziness show an increased fracture rate?

Retrospective cohort study using a population-based administrative database. A cohort of n=2,442 patients with at least one diagnosis of dizziness between 01/1998 and 06/2003 was compared with n=16,125 age- and sex-matched control patients. The main outcome measure was any kind of first fracture after the index date of dizziness. In addition, we stratified by osteoporotic and non-osteoporotic fractures. Statistical analysis was performed using the Cox proportional hazard regression model adjusting for possible confounders.

Analysis revealed a significant effect of dizziness as an independent contributing factor to fractures (HR 1.26; 95%CI: 1.03-1.55). Moreover, a fracture in the year prior to the index date was highly associated with the incidence of a subsequent fracture (HR 2.69; 2.09-3.47) as well as male gender was (HR 1.30; 1.18-1.40). Stratified analysis revealed that each of these factors had an independent effect on non-osteoporotic fractures (n=569), the HR of dizziness being 1.31 (95%CI: 1.05-1.64). Osteoporotic fractures, however, were strongly correlated only with a precedent fracture (HR 3.91; 2.31-6.63); they were more frequent in female patients (HR 1.39; 0.97-1.98).

Besides the “typical” elderly female patients at risk of osteoporotic fractures, male patients suffering from dizziness should be carefully evaluated, and prevention strategies should be considered in order to minimize their risk of suffering non-osteoporotic fractures.