Association of sepsis with risk for osteoporosis:​ a population-based cohort study

Lee, Y.-F.; Tsou, H.-K.; Leong, P.-Y.; Wang, Y.-H.; Wei, J. C.-C.

Affiliations

¹Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

²Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan

³Functional Neurosurgery Division, Neurological Institute, Taichung

⁴Veterans General Hospital, Taichung, Taiwan

⁵Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan

⁶Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan

⁷Department of Rheumatology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China

⁸Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

⁹Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan

¹⁰Institute of Medicine, College of medicine, Chung Shan Medical University, Taichung, Taiwan

¹¹Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

Abstract and keywords

Summary: We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database to evaluate whether the risk of developing osteoporosis is associated with sepsis. Our study found that adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis.

Introduction: There have been limited studies regarding the osteoporosis risk associated with sepsis. Our purpose is to evaluate whether the risk of developing osteoporosis is associated with sepsis.

Methods: We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database. From the insurance claims data, a total of 13,178 patients diagnosed with sepsis from 2000 to 2012 were included in the sepsis cohort, and a propensity score-matched cohort included 13,178 individuals without sepsis. To calculate the incidence of osteoporosis, both groups were followed until 2013. Cox regression analysis was performed to obtain the hazard ratios (HRs) to assess the risk of developing osteoporosis. The Kaplan–Meier method was used to estimate the cumulative incidence of osteoporosis.

Results: The overall incidences of osteoporosis (per 1,000 person-years) in the sepsis and non-sepsis groups were 10.2 and 10.7, respectively. The risk of osteoporosis significantly increased in the presence of sepsis (adjusted HR = 1.17, 95% confidence interval (CI) = 1.04–1.31). The risk of osteoporosis in the sepsis group was significantly higher than that in the non-sepsis group for young patients aged 20–49 years and patients aged 50–64 years (adjusted HR = 1.93, 95% CI = 1.08–3.44; adjusted HR = 2.01, 95% CI = 1.52–2.65, respectively). The Kaplan–Meier curves of cumulative probability also showed a significantly increased risk of osteoporosis in patients aged 20–49 years and aged 50–64 years with sepsis compared with non-sepsis (P = 0.025; P < 0.001, respectively).

Conclusion: Adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis.

Keywords: Cohort study; Osteoporosis; Risk; Sepsis

Links

DOI: 10.1007/s00198-020-05599-3

PubMed: 32827276

WoS: 000561725500001

History

Received: 2020-01-02

Accepted: 2020-08-11

Online: 2020-08-22

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