Hongo Takashi, Kotake Kazumasa, Muramatsu Hirotada, Omura Daisuke, Yano Yudai, Hasegawa Daisuke, Momoki Noriya, Takahashi Kenji, Nozaki Satoshi, Fujiwara Toshifumi
Emergency Department Okayama Saiseikai General Hospital Okayama Japan.
Pharmacy Department Okayama Saiseikai General Hospital Okayama Japan.
Acute Med Surg. 2019 Feb 28;6(2):173-179. doi: 10.1002/ams2.401. eCollection 2019 Apr.
To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis.
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 -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.
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 ( < 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.
We found that sepsis was associated with loss in BMD following critical care.
使用腹部计算机断层扫描检查脓毒症治疗患者的椎骨骨密度（BMD）变化。
进行了一项单中心、回顾性观察研究，以评估2016年1月至2018年4月在冈山西条综合医院（日本冈山）接受重症监护后的骨密度。脓毒症定义为重症监护病房或高级护理病房中序贯器官衰竭评估评分绝对增加≥2。通过计算机断层扫描以亨氏单位（HU）评估骨密度。根据是否存在骨质疏松症将患者分组，骨质疏松症定义为平均椎体HU<110。使用配对t检验比较重症监护前后每个椎骨的平均骨密度。我们还分析了出院后的意外骨折事件。使用Kaplan-Meier方法分析生存率作为结果。
188例患者中有52例符合纳入标准。我们发现胸12、腰1-5和骶1水平脊柱的入院和随访椎骨骨密度值之间存在显著差异（<0.05），尤其是在非骨质疏松症组中。骨质疏松症患者和非骨质疏松症患者之间未观察到死亡率差异。19例骨质疏松症患者中有2例发生骨折。
我们发现脓毒症与重症监护后骨密度降低有关。
