Vertebral fractures predict mortality, but little is known about their associations with the causes of death. We studied vertebral fractures for prediction of cause-specific mortality.

A nationally representative sample of 3,210 men and 3,730 women participated Mini-Finland health survey in 1978–1980. Vertebral fractures at the Th1–Th12 levels were identified from chest radiographs at baseline. Cox’s proportional hazard model was used to estimate the strength of association between vertebral fracture and mortality.

The relative risk (95% confidence interval) of death from natural causes was 1.49 (0.89–2.48) in men and 0.89 (0.60–1.31) in women with vertebral fractures (adjusted for age, body mass index, serum 25-hydroxyvitamin D, educational level, smoking, alcohol intake, physical activity and self-rated general health). Among women the adjusted relative risk of an injury death was 8.51 (3.48–20.77), whereas none of the men with vertebral fracture died due to an injury.

The patterns of mortality predicted by fracture in the thoracic spine differ between men and women.