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A7507 - Non-Traumatic Vertebral Fractures Among Chronic Obstructive Pulmonary Disease (COPD) Patients
Author Block: G. Epstein Shochet1, M. Koslow2, D. A. King3, D. Shitrit4; 1Pulmonary department, Meir Medical Center, Kfar Saba, Israel, 2Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States, 3Pulmonary and Respiratory Intensive Care, Meir Medical Center, Kfar Saba, Israel, 4Pulmonology, Meir medical center, Kfar Saba, Israel.
Objective: Chronic obstructive pulmonary disease (COPD) patients have disease manifestations outside of the respiratory system, such as weight loss, cardiovascular disease, depression and skeletal muscle dysfunction. Chronic systemic inflammation is thought to be an underlying cause of these effects. COPD and osteoporosis are strongly associated because of common risk factors such as age, decreased activity and tobacco use. Furthermore, the use of corticosteroids further exacerbates bone destruction. In this study, we compared the lateral chest radiographs of COPD patients to healthy controls for the rate and risk factors associated with non-traumatic vertebral fractures. Study design: All patients with a diagnosis of COPD, defined by lung function and clinical diagnosis, per electronic medical record at Meir Medical Center were identified (2009-2015). 1465 COPD patients were screened and randomly age matched to patients without known pulmonary disease (asthma or COPD). For the COPD patients, additional clinical variables were collected including age, gender, BMI, lung function, Charlson morbidity index, and mortality. Patients without a quality lateral radiograph were excluded. The semi quantitative technique, described by Genant et al, was used to assess the presence and severity of vertebral fracture. Results: 1,051 COPD patients were compared to healthy patients (n=624) that all had quality lateral chest radiographs. The overall fracture rate was 8.8% vs. 6.1% for the COPD and control group, respectively (p=0.049). Age-adjusted logistic regression for fracture revealed significantly increased risk for the COPD group vs. the control, 1.71 (1.12- 2.5, p=0.015). Moreover, an increased mortality rate was significantly associated with fractures compared to those without fractures 54.7% vs. 38.7% (p=0.013). Discussion and Conclusions: COPD patients are at greater risk for osteoporotic vertebral fractures that occur at a younger age. We believe the fracture rate is associated with the severity of lung disease and may explain the increased risk of mortality.