Mohammed S Shaheen1, Jonathan I Silverberg2. 1. From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, and. 2. Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Abstract
Background: Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. Objective: To determine whether asthma is associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. Methods: A cross-sectional study of 198,102,435 children and adults, including 10,129,307 with asthma, from the 2006-2012 National Emergency Department Sample, which includes a representative 20% sample of emergency department (ED) visits throughout the United States. Results: ED visits of patients with versus without asthma were associated with higher odds of osteopenia (7 of 7 years: multivariable logistic regression of all years pooled; adjusted odds ratio [aOR] 1.45 [95% confidence interval {CI}, 1.41-1.50]), osteoporosis (7 of 7 years: aOR 1.85 [95% CI, 1.82-1.88]), osteomalacia (7 of 7 years: aOR 2.00 [95% CI, 1.61-2.49]), and pathologic fractures (7 of 7 years: OR 1.24 [95% CI, 1.20-1.27]). Patients with asthma and with long-term glucocorticoid use had higher odds of osteoporosis, osteopenia, osteomalacia, and fractures compared with patients with asthma and without long-term glucocorticoid use. Patients with asthma and with fractures incurred significantly more inpatient admissions, and higher costs of ED and inpatient care. Conclusion: ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.
Background: Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. Objective: To determine whether asthma is associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. Methods: A cross-sectional study of 198,102,435 children and adults, including 10,129,307 with asthma, from the 2006-2012 National Emergency Department Sample, which includes a representative 20% sample of emergency department (ED) visits throughout the United States. Results: ED visits of patients with versus without asthma were associated with higher odds of osteopenia (7 of 7 years: multivariable logistic regression of all years pooled; adjusted odds ratio [aOR] 1.45 [95% confidence interval {CI}, 1.41-1.50]), osteoporosis (7 of 7 years: aOR 1.85 [95% CI, 1.82-1.88]), osteomalacia (7 of 7 years: aOR 2.00 [95% CI, 1.61-2.49]), and pathologic fractures (7 of 7 years: OR 1.24 [95% CI, 1.20-1.27]). Patients with asthma and with long-term glucocorticoid use had higher odds of osteoporosis, osteopenia, osteomalacia, and fractures compared with patients with asthma and without long-term glucocorticoid use. Patients with asthma and with fractures incurred significantly more inpatient admissions, and higher costs of ED and inpatient care. Conclusion: ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.