Acute exacerbation of COPD increases the risk of hip fractures: a nested case-control study from the Korea National Health Insurance Service
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Hip fracture and acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) could increase mortality in patients with COPD. There are no data on the relationship between AE-COPD and hip fracture, which may significantly affect the prognosis of patients with COPD. Therefore, we conducted this study to determine the effects of AE-COPD on hip fractures in patients with COPD. Methods: This retrospective, nested, case-control study included 253,471 patients with COPD (≥ 40 years of age) identified from the Korea National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) from 2002 to 2015. Among 176,598 patients with COPD, 1,415 patients with hip fractures were identified. Each case was matched to one control for age (within 10 years), sex, and year of COPD diagnosis. We estimated the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for hip fractures associated with AE-COPD using conditional logistic regression analysis, adjusting for underlying diseases and smoking history. Results: In patients with AE-COPD, the risk of hip fracture was 2.50 times higher, regardless of systemic corticosteroid use and underlying disease (aOR, 2.50; 95% CI, 1.67 to 3.75). The risk of hip fracture increased if there was one episode of AE in the year before hip fractures (aOR, 2.25; 95% CI, 1.66 to 3.05). Moreover, the risk of hip fracture also increased in patients with more than two episodes of AE the year before hip fractures (aOR, 2.57; 95% CI, 1.61 to 4.10). Conclusions: AE-COPD increases the risk of hip fracture regardless of underlying diseases, including osteoporosis, and treatment with systemic corticosteroids.
Abstract
Background/Aims: Hip fracture and acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) could increase mortality in patients with COPD. There are no data on the relationship between AE-COPD and hip fracture, which may significantly affect the prognosis of patients with COPD. Therefore, we conducted this study to determine the effects of AE-COPD on hip fractures in patients with COPD. Methods: This retrospective, nested, case-control study included 253,471 patients with COPD (≥ 40 years of age) identified from the Korea National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) from 2002 to 2015. Among 176,598 patients with COPD, 1,415 patients with hip fractures were identified. Each case was matched to one control for age (within 10 years), sex, and year of COPD diagnosis. We estimated the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for hip fractures associated with AE-COPD using conditional logistic regression analysis, adjusting for underlying diseases and smoking history. Results: In patients with AE-COPD, the risk of hip fracture was 2.50 times higher, regardless of systemic corticosteroid use and underlying disease (aOR, 2.50; 95% CI, 1.67 to 3.75). The risk of hip fracture increased if there was one episode of AE in the year before hip fractures (aOR, 2.25; 95% CI, 1.66 to 3.05). Moreover, the risk of hip fracture also increased in patients with more than two episodes of AE the year before hip fractures (aOR, 2.57; 95% CI, 1.61 to 4.10). Conclusions: AE-COPD increases the risk of hip fracture regardless of underlying diseases, including osteoporosis, and treatment with systemic corticosteroids.
참고문헌 (25)
- Vogelmeier CF, "Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary", Am J Respir Crit Care Med, 195, pp.557~582 (2017)
- Mannino DM, "Global burden of COPD : risk factors, prevalence, and future trends", Lancet, 370, pp.765~773 (2007)
- Yamauchi Y, "Mortality associated with bone fractures in COPD patients", Int J Chron Obstruct Pulmon Dis, 11, pp.2335~2340 (2016)
- Amarilla-Donoso FJ, "Quality of life in elderly people after a hip fracture : a prospective study", Health Qual Life Outcomes, 18, pp.71~ (2020)
- Cornwall R, "Functional outcomes and mortality vary among different types of hip fractures : a function of patient characteristics", Clin Orthop Relat Res, 425, pp.64~71 (2004)
- Huang SW, "Chronic obstructive pulmonary disease increases the risk of hip fracture : a nationwide population-based cohort study", Sci Rep, 6, pp.23360~ (2016)
- de Luise C, "Chronic obstructive pulmonary disease and mortality following hip fracture : a population-based cohort study", Eur J Epidemiol, 23, pp.115~122 (2008)
- Romme EA, "Bone attenuation on routine chest CT correlates with bone mineral density on DXA in patients with COPD", J Bone Miner Res, 27, pp.2338~2343 (2012)
- Watanabe R, "Osteoporosis is highly prevalent in Japanese males with chronic obstructive pulmonary disease and is associated with deteriorated pulmonary function", J Bone Miner Metab, 33, pp.392~400 (2015)
- Jaramillo JD, "Reduced bone density and vertebral fractures in smokers. Men and COPD patients at increased risk", Ann Am Thorac Soc, 12, pp.648~656 (2015)
- Seong SC, "Cohort profile : the National Health Insurance Service-National Health Screening Cohort(NHIS-HEALS)in Korea", BMJ Open, 7, pp.e016640~ (2017)
- 양형국, "Regional Factors Associated with Participation in the National Health Screening Program: A Multilevel Analysis Using National Data", Journal of Korean Medical Science, 28(3), pp.348~356 (2013), 대한의학회
- Maricic M, "American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis: comment on the article by Buckley et al", Arthritis Care Res(Hoboken), 70, pp.949~950 (2018)
- Weinstein RS, "Glucocorticoid-induced osteoporosis and osteonecrosis", Endocrinol Metab Clin North Am, 41, pp.595~611 (2012)
- Han MK, "Chronic obstructive pulmonary disease phenotypes : the future of COPD", Am J Respir Crit Care Med, 182, pp.598~604 (2010)
- Lopez-Campos JL, "Heterogeneity of chronic obstructive pulmonary disease exacerbations : a two-axes classification proposal", Lancet Respir Med, 3, pp.729~734 (2015)
- Seemungal TA, "Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 157(5 Pt 1), pp.1418~1422 (1998)
- Halpin DMG, "Effect of a single exacerbation on decline in lung function in COPD", Respir Med, 128, pp.85~91 (2017)
- Halpin DM, "Impact and prevention of severe exacerbations of COPD : a review of the evidence", Int J Chron Obstruct Pulmon Dis, 12, pp.2891~2908 (2017)
- Sharafkhaneh A, "Mortality in patients admitted for concurrent COPD exacerbation and pneumonia", COPD, 14, pp.23~29 (2017)
- Buckley L, "Glucocorticoid-induced osteoporosis", N Engl J Med, 379, pp.2547~2556 (2018)
- Hansen KE, "Uncertainties in the prevention and treatment of glucocorticoid-induced osteoporosis", J Bone Miner Res, 26, pp.1989~1996 (2011)
- Kameyama N, "Predictive and modifying factors of bone mineral density decline in patients with COPD", Respir Med, 148, pp.13~23 (2019)
- Fabbri LM, "Complex chronic comorbidities of COPD", Eur Respir J, 31, pp.204~212 (2008)
- Nadesalingam K, "Intermittent glucocorticoid use in chronic obstructive pulmonary disease patients : an audit of the prescribing of bone protection", Rheumatology, 53(Suppl 1), pp.i82~ (2014)