椎体压缩性骨折可能会增加慢性阻塞性肺疾病男性患者的死亡率。

Vertebral compression fractures may increase mortality in male patients with chronic obstructive pulmonary disease.

作者信息

Kim G-W, Joo H-J, Park T S, Lee J S, Lee S W, Jung Y J, Lee S-D, Oh Y-M

机构信息

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Pulmonary and Critical Care Medicine, Cheongju St Mary's Hospital, Cheonju, Seoul, Korea.

出版信息

Int J Tuberc Lung Dis. 2015 May;19(5):603-9. doi: 10.5588/ijtld.14.0754.

DOI:10.5588/ijtld.14.0754

PMID:25868031

Abstract

BACKGROUND

Vertebral compression fracture (VCF) is frequent in chronic obstructive pulmonary disease (COPD) patients. However, little is known about whether VCF affects mortality in COPD patients.

OBJECTIVE

To investigate whether VCFs might increase death in COPD patients.

METHODS

In this retrospective cohort study, we enrolled 254 COPD patients with a recent history of hospitalisation due to respiratory problems. Patients were assessed for VCF using quantitative morphometric analyses of lateral chest radiographs; 211 patients received follow-up examinations for 2 years.

RESULTS

Of the 211 COPD patients analysed, 60 (28.4%) had VCF at enrolment. During the follow-up period, 33/60 (55.0%) patients with and 46/151 patients (30.5%) without VCF died (P = 0.003, log-rank test). Cox proportional hazard analysis revealed that VCF is an independent risk factor for death after adjusting for age, sex, body mass index, smoking, dyspnoea scale, forced expiratory volume in 1 sec (FEV1) and comorbidities (hazard ratio for VCF = 1.79, 95%CI 1.11-2.89, P = 0.02).

CONCLUSION

VCF might be an independent risk factor for death in male COPD patients.

摘要

背景

椎体压缩性骨折（VCF）在慢性阻塞性肺疾病（COPD）患者中很常见。然而，关于VCF是否影响COPD患者的死亡率知之甚少。

目的

研究VCF是否可能增加COPD患者的死亡风险。

方法

在这项回顾性队列研究中，我们纳入了254例近期因呼吸问题住院的COPD患者。通过对胸部侧位X线片进行定量形态学分析来评估患者是否存在VCF；211例患者接受了为期2年的随访检查。

结果

在分析的211例COPD患者中，60例（28.4%）在入组时有VCF。在随访期间，有VCF的60例患者中有33例（55.0%）死亡，无VCF的151例患者中有46例（30.5%）死亡（P = 0.003，对数秩检验）。Cox比例风险分析显示，在调整年龄、性别、体重指数、吸烟、呼吸困难量表、第1秒用力呼气量（FEV1）和合并症后，VCF是死亡的独立危险因素（VCF的风险比=1.79，95%CI 1.11 - 2.89，P = 0.02）。