Fracture risk of patients suffering from dizziness: A retrospective cohort study

Abstract

Background: Dizziness is known to be associated with the risk of falls. However, there is not much evidence for the increase of fractures caused by dizziness. Objectives: The aim of the study was to investigate whether the symptom of dizziness is associated with an increased fracture rate. Methods: We performed a retrospective cohort study using a population-based administrative database in the Province of Quebec, Canada. A cohort of n = 2 442 patients with at least one diagnosis of dizziness was compared to n = 16 125 unexposed patients. The main outcome measure was any kind of first fracture after the index date of dizziness. Results: Analysis revealed a moderate effect of dizziness as an independent contributing factor to fractures (adjusted hazard ratio (HR) 1.26, 95% confidence interval 1.03 to 1.55). A fracture in the year before the index date was highly associated with the incidence of a subsequent fracture (HR 2.69, 2.09 to 3.47), and fractures were less frequent in women (HR 0.70, 0.60–0.82). Analysis further revealed that dizziness (HR 1.31, 1.05–1.64) and prior fractures (HR 2.41, 1.81–3.22) were associated with non-osteoporotic fractures, which were also less frequent in women (HR 0.59, 0.50–0.71). The incidence of fractures in sites typical for osteoporosis correlated with a precedent fracture (HR 3.91, 2.31–6.63), but not with dizziness (HR 1.10, 0.69–1.75).Conclusion: Besides the ‘typical’ elderly female patient being at risk of osteoporotic fractures, male patients suffering from dizziness should be carefully evaluated, and prevention strategies should be considered to minimise their risk of suffering non-osteoporotic fractures.