AIM: Osteoporosis is a frequent comorbidity in patients with chronic obstructive 
pulmonary disease (COPD). We have studied the risk of major osteoporotic 
fracture and hip fracture in patients with COPD.
PATIENTS AND METHODS: A multicenter cross-sectional study was performed in Spain 
in 26 hospitals of 16 regional communities. Patients diagnosed with COPD who 
required admission to the Internal Medicine Service due to exacerbation of their 
respiratory disease were enrolled. COPD was confirmed by post-bronchodilator 
spirometry in stable state: maximum expiratory volume in the first second (FEV₁) 
< 80% of the theoretical value and quotient FEV(1)/FVC < 0.70 and percent 
predicted after the administration of a bronchodilator. Dyspnea was evaluated 
with the modified Medical Research Council (mMRC) dyspnea scale. The principal 
variable was the likelihood of fracture evaluated with the FRAX® tool for the 
Spanish population.
RESULTS: Three hundred and ninety two patients, 347 (88%) men, with a mean (SD) 
age of 73.7 (8.9) years and a mean FEV₁ of 1.23 liters (43.3% of predicted) were 
enrolled. Only 37 patients (9.4%), 27 men and 10 women had been diagnosed 
previously of osteoporosis. Overall, 1.8% (95% CI: 0.9-3.6) had a 10-year 
probability of major osteoporotic fracture ≥ 20% and 49.7% (95% CI: 44.8-54.7) 
had a probability of hip fracture ≥ 3%. No relationship was observed between the 
probability of fracture and GOLD stage or mMRC dyspnea scale.
CONCLUSIONS: The diagnosis of osteoporosis is uncommon in our COPD patients. 
However, half of them have a high probability of a hip fracture in the next 10 
years.