Byunghyun Kim1, Joonghee Kim1, You Hwan Jo1, Si-Hyuck Kang2, Yeon Joo Lee3, Jae Hyuk Lee1, Je Eun Hwang1, Min Ji Park1, Sihyung Lee1. 1. Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. 2. Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. 3. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Abstract
STUDY DESIGN: Retrospective large population-based study. OBJECTIVE: The aim of this study is to elucidate the association between vertebral compression fractures (VCFs) and pneumonia. SUMMARY OF BACKGROUND DATA: VCF is known to be associated with impaired pulmonary function. However, the risk of developing pneumonia after new-onset VCF has not been evaluated. METHODS: The data source was the National Health Screening Program Cohort, a population-based sample cohort of national health screening enrolees. Elderly women with low bone density identified during the life transition period health check-up were target population. Patients with newly diagnosed isolated VCF after the health check-up except those with cervical VCF were included as exposure group. Matched individuals still free of any type of VCF from the same population were included as control group with case/control ratio 3:1. The time to first occurrence of pneumonia were analyzed with Cox-regression analysis. RESULTS: From the target population (N = 24,773), we matched 867 patients exposed to new-onset isolated VCFs with 2601 controls. In a multivariable Cox-regression analysis, isolated VCF was identified as an independent risk factor for development of a pneumonia (adjusted hazard ratio, 1.48; 95% confidence interval 1.14-1.91). Among the subtypes of VCF, thoracic/thoracolumbar VCF was independently associated with increased risk of pneumonia (adjusted hazard ratio, 2.13; 95% confidence interval 1.47-3.08). CONCLUSION: Isolated VCF, especially those involving thoracic region, was associated with increased risk of pneumonia. LEVEL OF EVIDENCE: 4.
STUDY DESIGN: Retrospective large population-based study. OBJECTIVE: The aim of this study is to elucidate the association between vertebral compression fractures (VCFs) and pneumonia. SUMMARY OF BACKGROUND DATA: VCF is known to be associated with impaired pulmonary function. However, the risk of developing pneumonia after new-onset VCF has not been evaluated. METHODS: The data source was the National Health Screening Program Cohort, a population-based sample cohort of national health screening enrolees. Elderly women with low bone density identified during the life transition period health check-up were target population. Patients with newly diagnosed isolated VCF after the health check-up except those with cervical VCF were included as exposure group. Matched individuals still free of any type of VCF from the same population were included as control group with case/control ratio 3:1. The time to first occurrence of pneumonia were analyzed with Cox-regression analysis. RESULTS: From the target population (N = 24,773), we matched 867 patients exposed to new-onset isolated VCFs with 2601 controls. In a multivariable Cox-regression analysis, isolated VCF was identified as an independent risk factor for development of a pneumonia (adjusted hazard ratio, 1.48; 95% confidence interval 1.14-1.91). Among the subtypes of VCF, thoracic/thoracolumbar VCF was independently associated with increased risk of pneumonia (adjusted hazard ratio, 2.13; 95% confidence interval 1.47-3.08). CONCLUSION: Isolated VCF, especially those involving thoracic region, was associated with increased risk of pneumonia. LEVEL OF EVIDENCE: 4.
Authors: En Loong Soon; Adriel Zhijie Leong; Jean Chiew; Arun-Kumar Kaliya-Perumal; Chun Sing Yu; Jacob Yoong-Leong Oh Journal: Asian Spine J Date: 2019-03-15