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Archives of Osteoporosis

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01-12-2018 | Original Article

Changes in bone mineral density in women before critical illness: a matched control nested cohort study

Authors: Neil R. Orford, Michael Bailey, Rinaldo Bellomo, Julie A. Pasco, David J. Cooper, Mark A. Kotowicz

Published in: Archives of Osteoporosis | Issue 1/2018

Abstract

Summary

The contribution of premorbid bone health to accelerated bone loss following critical illness is unknown. This study compared bone density in women before critical illness to women who did not become critically ill. Overall bone density was similar, although femoral neck bone mass increased immediately prior to critical illness.

Purpose

The relative contribution of acute and chronic factors to accelerated loss of bone mineral density (BMD) following critical illness is unknown. This study compared the BMD trajectory of women before critical illness to the BMD trajectory of women who did not become critically ill.

Methods

This prospective, nested, age- and medication-matched, case-control study compared trajectory of BMD in women in the Geelong Osteoporosis study (GOS) requiring admission to an Australian Intensive Care Unit (ICU) between June 1998 and March 2016, to women not admitted to ICU. The main outcome was age and medication use adjusted change in BMD.

Results

A total of 52 women, with a mean age of 77 ± 9 years were admitted to ICU, predominantly post-surgery (75%), during the study period. A greater age-adjusted annual rate of decline was observed for pre-ICU women compared to no-ICU women for AP spine BMD (−0.010 ± 0.002 g/cm² vs −0.005 ± 0.002 g/cm², p = 0.01) over the 15-year study period. In participants with multiple BMDs 2 years before critical illness, a significantly greater increase in femoral neck BMD compared to age- and medication-matched controls was observed (difference in BMD, ICU vs no-ICU = 0.037 ± 0.013 g/cm², p = 0.006).

Conclusion

In a cohort of women with predominantly surgical ICU admission, bone health prior to critical illness was comparable to age- and medication-matched controls, with a relative increase in femoral neck bone mass immediately prior to critical illness. These findings suggest critical illness-related bone loss cannot be entirely explained as a continuation of pre-morbid bone trajectory.

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Title: Changes in bone mineral density in women before critical illness: a matched control nested cohort study
Authors: Neil R. Orford
Michael Bailey
Rinaldo Bellomo
Julie A. Pasco
David J. Cooper
Mark A. Kotowicz
Publication date: 01-12-2018
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-018-0533-6

At a glance: The STEP trials

Springer Medicine

Changes in bone mineral density in women before critical illness: a matched control nested cohort study

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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