Loss of bone mineral density following sepsis using Hounsfield units by computed tomography

Abstract

Aim To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis. Methods A single‐center, retrospective, observational study was undertaken to evaluate BMD after critical care at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2016 to April 2018. Sepsis was defined as an absolute increase of ≥2 in Sequential Organ Failure Assessment score in the intensive care unit or high care unit. Bone mineral density was evaluated in Hounsfield units (HU) by computed tomography. Patients were divided into groups based on the presence or absence of osteoporosis, which was defined as average vertebral body HU <110. Paired t‐tests were used to compare the mean BMD of each vertebra between before and after critical care. We also analyzed accidental bone fracture events after discharge. The survival rate was analyzed as an outcome using the Kaplan–Meier method. Results Fifty‐two of 188 patients met the inclusion criteria. We found significant differences between admission and follow‐up vertebral BMD values in the spine at the thoracic 12, lumbar 1–5, and sacrum 1 levels (P < 0.05), especially in the non‐osteoporosis groups. No difference in mortality was observed between patients with osteoporosis and those without. Two of 19 patients with osteoporosis developed a bone fracture. Conclusion We found that sepsis was associated with loss in BMD following critical care.

Early Nutrition during Hospitalization in Relation to Bone Health in Preterm Infants at Term Age and Six Months Corrected Age

“…Sick neonates are therefore more at risk of growth failure [ 49 ], thus potentially effecting bone health. Similar results have been reported in adult studies on illnesses and bone health, an association between sepsis and loss in BMD is observed [ 50 , 51 ].…”

Trelagliptin stimulates osteoblastic differentiation by increasing runt-related transcription factor 2 (RUNX2): a therapeutic implication in osteoporosis

“…OP is defined as a systemic bone disease that results from decreased bone mass, increased osteopsathyrosis, declined bone mineral density (BMD), and elevated fracture risk [4]. Significant high morbidity of OP is reported in the elderly population and postmenopausal women.…”

“…Bone loss is induced when the process of bone resorption exceeds bone formation, contributing to the pathogenesis of osteoporosis (OP) [ 1–3 ]. OP is defined as a systemic bone disease that results from decreased bone mass, increased osteopsathyrosis, declined bone mineral density (BMD), and elevated fracture risk [ 4 ]. Significant high morbidity of OP is reported in the elderly population and postmenopausal women.…”

ICU admission body composition: skeletal muscle, bone, and fat effects on mortality and disability at hospital discharge—a prospective, cohort study

“…Likewise, while fat/SAT measurement at the thoracic 7–8 level has not been validated for ICU patients, it has shown to be highly correlated with the thoracic adipose tissue volume and with body mass index [ 19 ]. CT scan bone density has been previously used in critical illness and other settings [ 21 , 32 ], and although it has comparable performance to dual X-ray absorptiometry (DXA) scan at the femoral neck level [ 33 ], it has not been validated in the ICU setting. Fourth, because patients were enrolled after they had already developed critical illness, we had to select a surrogate measure of prehospitalization mobility status.…”