Association of sepsis with risk for osteoporosis: a population-based cohort study
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ORIGINAL ARTICLE
Association of sepsis with risk for osteoporosis: a population-based cohort study Y.-F. Lee 1,2 & H.-K. Tsou 3,4 & P.-Y. Leong 1,5 & Y.-H. Wang 6 & J. C.-C. Wei 7,8,9,10,11 Received: 2 January 2020 / Accepted: 11 August 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database to evaluate whether the risk of developing osteoporosis is associated with sepsis. Our study found that adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis. Introduction There have been limited studies regarding the osteoporosis risk associated with sepsis. Our purpose is to evaluate whether the risk of developing osteoporosis is associated with sepsis. Methods We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database. From the insurance claims data, a total of 13,178 patients diagnosed with sepsis from 2000 to 2012 were included in the sepsis cohort, and a propensity score-matched cohort included 13,178 individuals without sepsis. To calculate the incidence of osteoporosis, both groups were followed until 2013. Cox regression analysis was performed to obtain the hazard ratios (HRs) to assess the risk of developing osteoporosis. The Kaplan–Meier method was used to estimate the cumulative incidence of osteoporosis. Results The overall incidences of osteoporosis (per 1,000 person-years) in the sepsis and non-sepsis groups were 10.2 and 10.7, respectively. The risk of osteoporosis significantly increased in the presence of sepsis (adjusted HR = 1.17, 95% confidence interval (CI) = 1.04–1.31). The risk of osteoporosis in the sepsis group was significantly higher than that in the non-sepsis group for young patients aged 20–49 years and patients aged 50–64 years (adjusted HR = 1.93, 95% CI = 1.08–3.44; adjusted HR = 2.01, 95% CI = 1.52–2.65, respectively). The Kaplan–Meier curves of cumulative probability also showed a significantly increased risk of osteoporosis in patients aged 20–49 years and aged 50–64 years with sepsis compared with non-sepsis (P = 0.025; P < 0.001, respectively). Conclusion Adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis.
Y.-F. Lee and P.-Y. Leong contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-020-05599-3) contains supplementary material, which is available to authorized users. * J. C.-C. Wei [email protected] 1
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
2
Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
3
Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
4
Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaol
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