Yoon Seo Yeon, Lim Hyunsun, Cha Jun Min, Lee Sang Chul, Lee Jang Woo
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Yonsei Med J. 2025 Sep;66(9):582-589. doi: 10.3349/ymj.2024.0399.
This study investigated the risk factors for heterotopic ossification (HO) in patients with traumatic brain injury (TBI).
This was a retrospective study using the Korean National Health Insurance Service (KNHIS) database and included as many relevant factors as possible. Data were collected from the KNHIS cohort, a nationwide cohort covering the entire Korean population. Patients diagnosed with TBI from 2004 to 2018 were included. TBI was defined as individuals who 1) had been hospitalized, 2) were diagnosed with TBI under ICD-10 code S06, and 3) underwent brain imaging within 1 week before or after diagnosis. Among 637315 adult patients, 1909 (0.30%) developed HO. This study aimed to clarify the relationship between HO and various factors, including demographic and medical history, medication history, complications, and accompanying injuries in TBI patients.
Among TBI patients, HO was more common in female and peaked in patients in their 50s, with a lower incidence in their 70s. Preobesity and obesity were significant risk factors, while smokers had a reduced risk. HO was more common in patients with rheumatic diseases and medical comorbidities, and those who had undergone tracheostomies. The use of antiseptics was associated with an increased risk, whereas anticonvulsants, antithrombotics, steroids, and non-steroidal anti-inflammatory drugs were associated with lower risks. HO was more common in registered patients with disability due to brain lesion.
In conclusion, middle-age range, female sex, obesity, comorbidities, injury severity, systemic inflammation, and bony metabolism-affecting medications appear to increase the risk of HO in patients with TBI.
本研究调查了创伤性脑损伤（TBI）患者异位骨化（HO）的危险因素。
这是一项使用韩国国民健康保险服务（KNHIS）数据库的回顾性研究，纳入了尽可能多的相关因素。数据收集自KNHIS队列，这是一个覆盖韩国全体人口的全国性队列。纳入了2004年至2018年被诊断为TBI的患者。TBI定义为符合以下条件的个体：1）曾住院治疗；2）根据国际疾病分类第10版（ICD - 10）编码S06被诊断为TBI；3）在诊断前或诊断后1周内接受过脑部成像检查。在637315名成年患者中，1909名（0.30%）发生了HO。本研究旨在阐明HO与各种因素之间的关系，这些因素包括TBI患者的人口统计学和病史、用药史、并发症及伴随损伤。
在TBI患者中，HO在女性中更常见，在50多岁的患者中达到高峰，70多岁的患者发病率较低。超重和肥胖是显著的危险因素，而吸烟者风险降低。HO在患有风湿性疾病和其他合并症以及接受过气管切开术的患者中更常见。使用防腐剂与风险增加相关，而抗惊厥药、抗血栓药、类固醇和非甾体抗炎药与风险降低相关。HO在因脑损伤而登记为残疾的患者中更常见。
总之，中年、女性、肥胖、合并症、损伤严重程度、全身炎症以及影响骨代谢的药物似乎会增加TBI患者发生HO的风险。
