Impact of the Blue Zone Lifestyle on Vertebral Compression Fracture Mortality: A Retrospective Cohort Analysis

BACKGROUND: Vertebral compression fractures (VCFs) are common fragility fractures and are associated with significant mortality and healthcare costs. "Blue Zones," regions with high longevity and low chronic disease rates, offer a unique opportunity to study how lifestyle factors influence fracture outcomes. METHODS: A retrospective cohort review of conservatively treated fragility VCFs diagnosed within emergency department encounters from January 2013 to December 2022 was conducted at a single tertiary care institution in the Blue Zone. Key variables collected include demographics, health metrics, and chronic medical conditions. Mortality was assessed through electronic medical records and public records (Google, Instant Checkmate database). 1:1 Propensity score matching (PSM) was used to minimize bias. RESULTS: The retrospective cohort review resulted in 105 Blue Zone and 544 non-Blue Zone patients. Before PSM, the average age at diagnosis of VCF in the Blue Zone was 76±13 years compared to 66±12 years (P