Impact of splenectomy on fracture risk via the bone-immune axis: A nationwide Korean cohort study
Main finding · Any fractureResult — go to the resultHazard ratio 1.61 95% CI 1.33–1.95Authors' conclusion
Our findings indicate that splenectomy is associated with an increased risk of fractures, particularly hip fractures, with the association being most pronounced among individuals who underwent traumatic splenectomy.
Study context
- Population
- Individuals participating in national health screenings by the Korean National Health Insurance Servicemedian follow-up 10.3 years
- Participants
- 3,125,549 individuals
- Exposure
- Splenectomy vs no splenectomy
- Splenectomyn = 769
- Outcome
- Incidence of new-onset fractures (hip, vertebral, or other fractures)
Methodological detailsnationwide, multivariable Cox proportional hazards models
- Nationwide
- Multivariable Cox proportional hazards models
Main finding
Any fracture
Hazard ratio
1.61
95% CI 1.33–1.95
Splenectomyvs No splenectomy
HR 1.61 (95% CI 1.33–1.95)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hip fracture | 2.57 (1.76–3.76) | |
| Other fractures | 1.36 (1.05–1.76) | |
| 0.20.5125Hazard ratio (log scale) |
Vertebral fracture
- Splenectomy not significantly associated with vertebral fracture risk in the overall population
Fractures after traumatic splenectomy (stratified by indication)
- Vertebral fracture, fold higher risk
- 3.27 (95% CI 1.06-10.15)
- Hip fractures, fold higher risk
- 7.86 (95% CI 2.95-20.95)
Vertebral fracture (subgroups)
- Significantly higher vertebral fracture risks among males and current drinkers
Original publication
Impact of splenectomy on fracture risk via the bone-immune axis: A nationwide Korean cohort study. Osteoporos Int. Published 20 March 2026. doi:10.
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