Computed tomographic bone mineral density is independently associated with adverse in-hospital outcomes in Dutch level-1 trauma patients.
Bone mineral density
Computed tomography
In-hospital complications
Opportunistic screening
Trauma patients
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
20
06
2022
accepted:
11
11
2022
medline:
1
6
2023
pubmed:
28
11
2022
entrez:
27
11
2022
Statut:
ppublish
Résumé
Aging, inactivity, and malnutrition are risk factors for adverse in-hospital outcomes and can manifest in bone loss. Use of bone mineral density (BMD) as an objective marker might improve early identification of patients at risk for complications. To assess the association of computed tomography (CT) determined BMD values of the first lumbar vertebra with in-hospital complications and outcomes in trauma patients. All consecutive hospitalized trauma patients (≥ 16 years) that underwent CT-imaging within 7 days of admission in 2017 were included. Patients with an active infection or antibiotic treatment upon admission, severe neurologic trauma, or an unassessable vertebra were excluded. BMD at the first lumbar vertebra was determined with CT by placing a circular region of interest in homogeneous trabecular bone to obtain mean Hounsfield Units (HU). Regression analyses were performed to assess the association of BMD with in-hospital complications and outcomes. In total, 410 patients were included (median age: 49 years [interquartile range 30-64], 68.3% men, mean BMD 159 ± 66 HU). A total of 94 complications, primarily infection-related, were registered in 74 patients. After adjustment for covariates, a decrease of BMD by one standard deviation was significantly associated with increased risk of complications (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1-3.1), pneumonia (OR 2.2, 95% CI 1.2-4.5), delirium (OR 4.5, 95% CI 1.7-13.5), and intensive care unit (ICU) admission (OR 1.8, 95% CI 1.1-2.9). Bone mineral density of the first lumbar vertebra is independently associated with in-hospital complications, pneumonia, delirium, and ICU admission. These findings could help identify patients at risk early.
Sections du résumé
BACKGROUND
BACKGROUND
Aging, inactivity, and malnutrition are risk factors for adverse in-hospital outcomes and can manifest in bone loss. Use of bone mineral density (BMD) as an objective marker might improve early identification of patients at risk for complications.
AIM
OBJECTIVE
To assess the association of computed tomography (CT) determined BMD values of the first lumbar vertebra with in-hospital complications and outcomes in trauma patients.
METHODS
METHODS
All consecutive hospitalized trauma patients (≥ 16 years) that underwent CT-imaging within 7 days of admission in 2017 were included. Patients with an active infection or antibiotic treatment upon admission, severe neurologic trauma, or an unassessable vertebra were excluded. BMD at the first lumbar vertebra was determined with CT by placing a circular region of interest in homogeneous trabecular bone to obtain mean Hounsfield Units (HU). Regression analyses were performed to assess the association of BMD with in-hospital complications and outcomes.
RESULTS
RESULTS
In total, 410 patients were included (median age: 49 years [interquartile range 30-64], 68.3% men, mean BMD 159 ± 66 HU). A total of 94 complications, primarily infection-related, were registered in 74 patients. After adjustment for covariates, a decrease of BMD by one standard deviation was significantly associated with increased risk of complications (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1-3.1), pneumonia (OR 2.2, 95% CI 1.2-4.5), delirium (OR 4.5, 95% CI 1.7-13.5), and intensive care unit (ICU) admission (OR 1.8, 95% CI 1.1-2.9).
CONCLUSION
CONCLUSIONS
Bone mineral density of the first lumbar vertebra is independently associated with in-hospital complications, pneumonia, delirium, and ICU admission. These findings could help identify patients at risk early.
Identifiants
pubmed: 36436071
doi: 10.1007/s00068-022-02175-8
pii: 10.1007/s00068-022-02175-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1393-1400Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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