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27.11.2022 | Original Article

Computed tomographic bone mineral density is independently associated with adverse in-hospital outcomes in Dutch level-1 trauma patients

verfasst von: Tim Kobes, Arthur A. R. Sweet, Sophie B. H. Verstegen, R. Marijn Houwert, Wouter B. Veldhuis, Luke P. H. Leenen, Pim A. de Jong, Mark C. P. M. van Baal

Erschienen in: European Journal of Trauma and Emergency Surgery

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Abstract

Background

Aging, inactivity, and malnutrition are risk factors for adverse in-hospital outcomes and can manifest in bone loss. Use of bone mineral density (BMD) as an objective marker might improve early identification of patients at risk for complications.

Aim

To assess the association of computed tomography (CT) determined BMD values of the first lumbar vertebra with in-hospital complications and outcomes in trauma patients.

Methods

All consecutive hospitalized trauma patients (≥ 16 years) that underwent CT-imaging within 7 days of admission in 2017 were included. Patients with an active infection or antibiotic treatment upon admission, severe neurologic trauma, or an unassessable vertebra were excluded. BMD at the first lumbar vertebra was determined with CT by placing a circular region of interest in homogeneous trabecular bone to obtain mean Hounsfield Units (HU). Regression analyses were performed to assess the association of BMD with in-hospital complications and outcomes.

Results

In total, 410 patients were included (median age: 49 years [interquartile range 30–64], 68.3% men, mean BMD 159 ± 66 HU). A total of 94 complications, primarily infection-related, were registered in 74 patients. After adjustment for covariates, a decrease of BMD by one standard deviation was significantly associated with increased risk of complications (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1–3.1), pneumonia (OR 2.2, 95% CI 1.2–4.5), delirium (OR 4.5, 95% CI 1.7–13.5), and intensive care unit (ICU) admission (OR 1.8, 95% CI 1.1–2.9).

Conclusion

Bone mineral density of the first lumbar vertebra is independently associated with in-hospital complications, pneumonia, delirium, and ICU admission. These findings could help identify patients at risk early.
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Literatur
Metadaten
Titel
Computed tomographic bone mineral density is independently associated with adverse in-hospital outcomes in Dutch level-1 trauma patients
verfasst von
Tim Kobes
Arthur A. R. Sweet
Sophie B. H. Verstegen
R. Marijn Houwert
Wouter B. Veldhuis
Luke P. H. Leenen
Pim A. de Jong
Mark C. P. M. van Baal
Publikationsdatum
27.11.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-02175-8

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