High prevalence of vertebral deformities in COPD patients: relationship to disease severity

Kjensli, A.; Falch, Jan A.; Ryg, Morten; Blenk, Tilo; Armbrecht, Gabriele; Diep, Lien My; Ellingsen, Ivar

doi:10.1183/09031936.00073908

Cited by 54 publications

(60 citation statements)

References 22 publications

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“…The finding that a decreasing BMI is associated with an increasing risk of osteoporosis is in line with several other studies in COPD patients [23][24]. Bolton and colleagues found the highest prevalence of osteoporosis (50%) and osteopenia (50%) in cachectic COPD patients ( Table 4).…”

Section: Discussionsupporting

confidence: 87%

Osteoporosis in COPD: Are Bones Brittle in COPD?

Bhat¹,

Mir²,

Koul³

2017

J Pulm Respir Med

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Section: Discussionsupporting

confidence: 87%

Osteoporosis in COPD: Are Bones Brittle in COPD?

Bhat¹,

Mir²,

Koul³

2017

J Pulm Respir Med

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“…(12,18,22) The prevalence of radiographic VFs in subjects with COPD as reported in the literature is varying between 9.0% and 79%, (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) with the prevalence of radiographic VFs in subjects with COPD increasing from 32% to 52% in a 3-year time period. (32) However, the incidence of clinical VFs in subjects with COPD was as low as 1.3/1000 person-years (35) to 6% over 2.6 years (36) and 0.5% to 1.0% within 3 years.…”

Section: Introductionmentioning

confidence: 99%

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

Dort

Geusens

Driessen

et al. 2018

Journal of Bone and Mineral Research

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Subjects with chronic obstructive pulmonary disease (COPD) have an increased risk of vertebral fractures (VFs); however, VF incidence is largely unknown. Therefore, the aim of our study was to determine the incidence of new and/or worsening VF in subjects with COPD. Smokers and subjects with COPD (GOLD II-IV) from the ECLIPSE study with complete set of chest CT scans (baseline and 1-and 3-year follow-up) to evaluate vertebrae T 1 down to L 1 were included. If a VF was diagnosed on the last scan, detailed VF assessment of the previous scans was performed. VFs were scored according to the method of Genant as mild, moderate, or severe. Main outcome measure was the cumulative incidence of new and/or worsening VF at subject level, within 1 and 3 years. Of 1239 subjects (mean age 61 years, 757 males [61%], 999 subjects with COPD), 253 (20.5%) had !1 prevalent VF. The cumulative incidence of VFs was 10.1% within 1 year and 24.0% within 3 years. After adjustment for age, sex, body mass index (BMI), pack-years, and smoking status, prevalence and incidence were similar between smokers and COPD GOLD stages. Within 1 year, 29.2% of the subjects with a prevalent VF had an incident VF, compared with 5.1% in absence of prevalent VF (hazard ratio [HR] ¼ 5.1; 95% confidence interval [CI] 3.6-7.4) and 58.5% versus 15.0% within 3 years (HR ¼ 3.6; 95% CI 2.9-4.6). The incidence of VF was higher with increasing number and severity of prevalent VFs. Among subjects having an incident VF within the first year, 57.3% had a subsequent VF within the next 2 years. In this study, more than half of the smokers and subjects with COPD with a prevalent VF or an incident VF within the first year sustained a subsequent VF within 3 years. The 3-year risk was even higher in the presence of multiple or severe prevalent VFs.

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“…Based on a pilot study, the number needed to demonstrate a 12% difference in forced expiratory volume in 1 s (FEV1) between patients with and without vertebral deformities was 462 COPD patients of both sexes at a significance level of 0.05 and a power of 0.80 [5].…”

Section: Methodsmentioning

confidence: 99%

“…Vertebral deformities are prevalent in chronic obstructive pulmonary disease (COPD) patients [5], and may lead to height reduction beyond what is normally expected with age. In such patients, predicted values will be underestimated and, thus, lung function overestimated.…”

mentioning

confidence: 99%

Does body height reduction influence interpretation of lung function in COPD patients?

Kjensli¹,

Ryg²,

Falch³

et al. 2010

European Respiratory Journal

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Vertebral deformities are prevalent in chronic obstructive pulmonary disease (COPD) patients and may cause excessive loss of height. As height is used for calculating reference values for pulmonary function tests, larger than normal height reduction could cause overestimation of lung function.In this cross-sectional study of 465 COPD patients and 462 controls, we explored how often lung function is misinterpreted due to height reduction in COPD patients, and whether the number or severity of vertebral deformities correlate with height reduction.Measured height was compared to recalled tallest height (RTH) and height calculated from arm span (ASH) to assess height reduction. Vertebral deformities were assessed from radiographs and pulmonary function was assessed using standard formulae.Height reduction was frequent in both the study and control groups, and increased with the number and severity of vertebral deformities. When using current measured height, lung function was overestimated in a significant proportion of COPD patients at relatively modest height reductions. The effects were smallest for forced expiratory volume in 1 s and forced vital capacity, and most pronounced for total lung capacity and residual volume. Therefore, we propose that in COPD patients with excessive height reduction, one might use RTH or ASH in calculating predicted values. Furthermore, such patients should be evaluated for co-existing vertebral deformities and osteoporosis.

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High prevalence of vertebral deformities in COPD patients: relationship to disease severity

Cited by 54 publications

References 22 publications

Osteoporosis in COPD: Are Bones Brittle in COPD?

Osteoporosis in COPD: Are Bones Brittle in COPD?

High Imminent Vertebral Fracture Risk in Subjects With COPD With a Prevalent or Incident Vertebral Fracture

Does body height reduction influence interpretation of lung function in COPD patients?

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