Risk factors for compression fractures in patients treated with gastrectomy: emphasis on bone mineral density measured on opportunistic CT
Suiji Lee, Seoul / Korea, Republic of
Author Block: S. Lee, K. W. Kim; Seoul/KRPurpose: The aim of this study was to assess apply osteosarcopenia measurement methods in CT patients. Osteosarcopenia is the coexistence of osteoporosis and sarcopenia, which has a significant impact on the survival outcomes of critically ill patients. Many studies tried to diagnose osteosarcopenia using opportunistic CT. However, in case of patients treated with gastrectomy, the loss of bone mineral density and muscle mass is not routinely evaluated, even though these patients often experience bone and muscle shrinkage and subsequent compression fractures after surgery. Therefore, we assessed bone mineral density (BMD) and skeletal muscle area (SMA) in these patients by applying osteosarcopenia measurement methods in opportunistic abdominal CT.Methods or Background: Among 2457 patients who had undergone gastrectomy between January 2003 and December 2010, we included 100 patients (mean age 58 years). Preoperative and 1-year postoperative abdominal CT scans were evaluated for BMD and SMA. Region of interest was situated in L1 vertebral body to estimate trabecular attenuation value to analyze BMD and SMA. To determine predictive risk factors for compression fractures, we implemented univariate logistic regression analysis.Results or Findings: Between preoperative and postoperative CT, all patients showed a decline in the SMA (116 ± 27 cm2 vs. 110 ± 25 cm2, p<- 0001) and the BMD (177 ± 50 HU vs. 166 ± 50 HU, p<0.0001). Body weight (60 ± 9 kg vs. 54 ± 9 kg, p<0.0001) and BMI (24 ± 3 vs. 21 ± 3, p<0.0001) were also decreased. During the five-year follow-up record, five patients experienced osteoporotic vertebral compression fractures. Univariate analysis showed preoperative and postoperative BMD were significant risk factors for compression fractures, apart from age, sex, preoperative and postoperative SMA.
Conclusion: Preoperative and postoperative BMD measured on opportunistic CT are significant risk factors for compression fractures in patients treated with gastrectomy.Limitations: Single center study and retrospective design.Funding for this study: No funding was obtained for this study.Has your study been approved by an ethics committee? YesEthics committee - additional information: The study was approved by the IRB with the approval code: 2023-