Hearing impairment increases the risk of distal radius, hip, and spine fractures: A longitudinal follow-up study using a national sample cohort

OBJECTIVE Hearing impairment has been suggested to increase the risk of falls. However, most previous studies were conducted in an older population without classification of the fracture regions. This study aimed to delineate the risk of each fracture type in all age populations. METHODS The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. A total of 4,854 severe hearing-impaired and 1,354 profound hearing-impaired participants were matched for age, group, sex, income group, and region of residence with 19,416 and 5,416 control participants, respectively. The fracture diagnosis was based on the International Classification of Disease (ICD-10) codes as follows: distal radius fracture (S525), hip fracture (S720, S721, S722), and spine fracture (S220, S32). Crude (simple) and adjusted hazard ratios (HRs) for each fracture associated with severe or profound hearing impairment were analyzed using the Cox proportional hazard model. RESULTS The severe hearing-impaired group had an increased risk of distal radius fracture, hip fracture, and spine fracture compared with the control group (adjusted HR = 1.67, 95% CI = 1.38-2.03, P < 0.001 for hip fracture). The profound hearing-impaired group had an increased risk of hip and spine fracture (adjusted HR = 2.21, 95% CI = 1.44-3.39, P < 0.001 for hip fracture). CONCLUSION The risk of distal radius fracture, hip fracture, and spine fracture was increased in the severe hearing-impaired group compared with the control group.