# Reduced walking speed at discharge predicts mortality after clinical osteoporotic vertebral fracture: A retrospective cohort study

## TL;DR

Slower walking speed at discharge predicts higher mortality in patients with osteoporotic vertebral fractures, emphasizing the importance of mobility in recovery.

## Contribution

Identifies walking speed as a novel prognostic indicator for mortality in patients with clinical osteoporotic vertebral fractures.

## Key findings

- A walking speed below 0.71 m/sec at discharge was associated with increased mortality in patients with osteoporotic vertebral fractures.
- The deceased group showed lower nutritional status (GNRI) and more calcification of vessels compared to survivors.
- Maintaining walking speed and preventing kyphotic deformity are essential for better outcomes in vertebral fracture treatment.

## Abstract

This study investigated how walking speed affects survival in patients with clinical osteoporotic vertebral fractures. A walking speed below 0.71 m/sec was associated with increased mortality. Walking speed may serve as a simple yet powerful prognostic indicator, highlighting the importance of mobility preservation in fracture management.

The number of patients with fractures caused by osteoporosis has increased with the increasing proportion of aging adults in recent years. Osteoporotic vertebral fractures (OVFs) are associated with poor prognosis. Although several reports on the life expectancy of patients with OVFs exist, it is unclear how walking speed affects the life expectancy of patients with clinical OVFs. This study investigated the relationship between walking speed and life expectancy after injury in patients with clinical OVFs.

A total of 104 patients with new clinical OVFs were conservatively treated with a trunk cast from 2015 to 2017. Lumbar spine and femur bone mineral density (BMD), the Geriatric Nutritional Risk Index (GNRI), walking speed, and spinopelvic parameters were measured. We compared the deceased and survival groups and examined the risk factors influencing survival.

Among the 104 patients included in the study, 67 were women; the median age was 82 years, and the median observation period was 1168 days. Thirty-two patients died during the observation period. The deceased group had a lower GNRI and a slower walking speed at discharge. In addition, imaging revealed more local kyphosis and more calcification of vessels in the deceased group. The risk of death increased when the walking speed after the OVF was less than 0.71 m/sec.

A walking speed of 0.71 m/sec or slower was associated with poor prognosis after clinical vertebral fracture. Nutritional management, kyphotic deformity prevention, and walking speed maintenance are essential for vertebral fracture treatment.

The online version contains supplementary material available at 10.1007/s11657-026-01686-w.