Document Detail


Prevalence and predictors of vertebral fracture in patients with chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  19828305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Patients with COPD are at risk for osteoporosis-related vertebral compression fractures (VCF) which predispose to more fractures and worsening pulmonary function. Our objectives were to: 1 document VCF prevalence in COPD patients; and 2 determine the independent correlates of VCF. METHODS: From 2004-2006, we prospectively recruited consecutive consenting COPD patients presenting with acute exacerbation at three Canadian Emergency Departments (ED). We collected clinical and pulmonary function data. Primary outcome was radiologist documented VCF on chest radiograph. Multivariable logistic regression was used for all adjusted analyses. RESULTS: Overall, 245 patients were studied; 37% were >or=75 years and 44% were women. Prevalence of VCF documented by chest radiograph was 22 of 245 (9%; 95%CI 6-13%). Almost half (10 of 22 [43%]) of VCF patients were not treated for osteoporosis and all 10 received oral steroids. Compared to patients without fractures, those with VCF were older (p=0.014), had COPD of longer duration (p=0.09) and greater severity (mean FEV(1) 0.9 vs 1.1L; p=0.05), and had lower body mass index [BMI] (median 26 vs 28; p=0.01). Across BMI quartiles (from heaviest [median 37] to lightest [median 21]) the prevalence of VCF progressively increased (2%, 8%, 10%, 21%; p<0.001). In analyses adjusted for age, sex, and COPD duration, the only independent correlate of VCF was BMI: VCF increased as BMI decreased from heaviest (OR=1) to lightest (OR=11.0) quartiles (p=0.025). CONCLUSIONS: Almost one-tenth of COPD patients presenting with acute exacerbation have chest radiographs documenting VCF. About half of patients with VCF were not treated for osteoporosis, but all were started on oral steroids. Our findings suggest chest radiograph reports may represent an important case-finding tool for VCF, particularly in underweight patients with COPD.
Authors:
Sumit R Majumdar; Cristina Villa-Roel; Kristin J Lyons; Brian H Rowe
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-10-14
Journal Detail:
Title:  Respiratory medicine     Volume:  104     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  260-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Alberta, 2F1.24 Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, Alberta, Canada. me2.majumdar@ualberta.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Bronchodilator Agents / adverse effects*
Canada / epidemiology
Female
Glucocorticoids / adverse effects*
Humans
Lumbar Vertebrae / injuries,  radiography*
Male
Middle Aged
Multivariate Analysis
Osteoporosis / chemically induced,  radiography*
Prevalence
Prospective Studies
Pulmonary Disease, Chronic Obstructive / complications*,  drug therapy
Spinal Fractures / chemically induced,  epidemiology,  radiography*
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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