TY - JOUR TI - Using vital statistics to estimate the population-level impact of osteoporotic fractures on mortality based on death certificates, with an application to France (2000-2004) AU - Ziadé, Nelly AU - Jougla, Eric AU - Coste, Joël T2 - BMC public health AB - BACKGROUND: We developed a methodology using vital statistics to estimate the impact of osteoporotic fractures on the mortality of an entire population, and applied it to France for the period 2000-2004. METHODS: Current definitions of osteoporotic fractures were reviewed and their components identified. We used the International Classification of Diseases with national vital statistics data for the French adult population and performed cross-classifications between various components: age, sex, I-code (site) and E-code (mechanism of fracture). This methodology allowed identification of appropriate thresholds and categorization for each pertinent component. RESULTS: 2,625,743 death certificates were analyzed, 2.2% of which carried a mention of fracture. Hip fractures represented 55% of all deaths from fracture. Both sexes showed a similar pattern of mortality rates for all fracture sites, the rate increased with age from the age of 70 years. The E-high-energy code (present in 12% of death certificates with fractures) was found to be useful to rule-out non-osteoporotic fractures, and to correct the overestimation of mortality rates. Using this methodology, the crude number of deaths associated with fractures was estimated to be 57,753 and the number associated with osteoporotic fractures 46,849 (1.85% and 1.78% of all deaths, respectively). CONCLUSION: Osteoporotic fractures have a significant impact on overall population mortality. DA - 2009/// PY - 2009 DO - 10.1186/1471-2458-9-344 DP - NCBI PubMed VL - 9 SP - 344 J2 - BMC Public Health LA - eng SN - 1471-2458 KW - Adult KW - Aged KW - Aged, 80 and over KW - Female KW - Fractures, Bone KW - France KW - Humans KW - Male KW - Middle Aged KW - Population Surveillance ER -