Contribution of hypoalbuminemia and decreased renal function to the increased mortality after newly diagnosed vertebral fracture in Japanese subjects
Contribution of hypoalbuminemia and decreased renal function to the increased mortality after newly diagnosed vertebral fracture in Japanese subjects
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DOI：
10.6133/apjcn.092015.17
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发表时间：
2016-09-01
影响因子：
1.3
通讯作者：
Tanaka, Kiyoshi
中科院分区：
文献类型：
--
作者：
Nakano, Tetsuo;Kuwabara, Akiko;Tanaka, Kiyoshi
背景和目标：关于椎体骨折（VFx）后的死亡率及其影响因素的报道很少，且仅限于流行的VFx。在本文中，我们研究了影响死亡率的因素后，新鲜诊断VFx。方法和研究设计：研究了759例年龄为78.8 ± 8.5岁的背部或腰部疼痛受试者，并通过MRI诊断为新鲜VFx，研究了他们的年龄、性别、普遍骨折数量、生存或死亡日期、Hb、白蛋白、C反应蛋白的循环浓度和估计的肾小球滤过率（eGFR）。进行考克斯比例风险分析以评估死亡率的显著预测因素。使用受试者操作特征（ROC）曲线分析死亡率变量的截止浓度。结果：中位观察时间为3.8年，3年生存率为78.8%。考克斯比例风险分析表明，血清白蛋白浓度（风险比（HR）=0.355）和eGFR（HR=0.993）是死亡率的重要预测因子。临界浓度分别为3.6 g/dL和60 mL/min/1.73m2。Kaplan-Meier曲线显示，血清白蛋白浓度和eGFR均低于这些截止浓度的患者的生存率显著降低。结论：目前的研究表明，营养不良和肾功能受损是VFx后死亡率的重要预测因素。
Background and Objectives: Reports on the mortality and its contributing factors after vertebral fracture (VFx) has been scarce, and limited to prevalent VFx. In this paper, we have studied the factors influencing mortality after freshly diagnosed VFx. Methods and Study Design: 759 subjects aged 78.8 +/- 8.5 years old with back or lumbar pain, and diagnosed as fresh VFx by MRI were studied for their age, gender, number of prevalent fracture (s), survival or the date of death, circulating concentrations of Hb, albumin, C reactive protein, and estimated glomerular filtration rate (eGFR). Cox's proportional hazard analysis was performed to assess the significant predictors for mortality. The cut-off concentrations of the variables for mortality were analyzed using the receiver operator characteristic (ROC) curve. Results: The median observation duration was 3.8 years, and 3-year survival rate was 78.8%. Cox's proportional hazard analysis has shown that serum albumin concentration (hazard ratio (HR) =0.355) and eGFR (HR=0.993) were significant predictors for mortality. The cut-off concentrations were 3.6 g/dL and 60 mL/min/1.73m(2), respectively. Kaplan-Meier curves revealed that survival rates were significantly decreased in patients with both serum albumin concentration and eGFR below these cut-off concentrations. Conclusions: The present study has revealed that malnutrition and impaired renal function were significant predictors for mortality after VFx.