Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality
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- 作者：C. F. Buckens (1) (2)
Y. van der Graaf (2)
H. M. Verkooijen (1)
W. P. Mali (1)
I. Isgum (3)
C. P. Mol (3)
H. J. Verhaar (4)
R. Vliegenthart (5)
M. Oudkerk (5)
C. M. van Aalst (6)
H. J. de Koning (6)
P. A. de Jong (1) - 关键词：Vertebral fracture ; Bone density ; Computed tomography ; Mortality ; Lung cancer screening
- 刊名：European Radiology
- 出版年：2015
- 出版时间：January 2015
- 年：2015
- 卷：25
- 期：1
- 页码：132-139
- 全文大小：304 KB
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15. Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O (2003) Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 14:61-8 Aalst (6)
H. J. de Koning (6)
P. A. de Jong (1)
1. Radiology Department, University Medical Center Utrecht, Heidelberglaan 100, E01.1A32, 3508 GA, Utrecht, The Netherlands
2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
3. Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
4. Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
5. Department of Radiology, Medical Center Groningen, Utrecht, The Netherlands
6. Department of Public Health, Erasmus MC Rotterdam, Rotterdam, The Netherlands - ISSN：1432-1084
文摘
Objectives Further survival benefits may be gained from low-dose chest computed tomography (CT) by assessing vertebral fractures and bone density. We sought to assess the association between CT-measured vertebral fractures and bone density with all-cause mortality in lung cancer screening participants. Methods Following a case-cohort design, lung cancer screening trial participants (N--,673) who died (N--96) during a median follow-up of 6?years (inter-quartile range: 5.7-.3) were identified and added to a random sample of N--83 from the trial. We assessed vertebral fractures using Genant′s semiquantative method on sagittal reconstructions and measured bone density (Hounsfield Units (HU)) in vertebrae. Cox proportional hazards modelling was used to determine if vertebral fractures or bone density were independently predictive of mortality. Results The prevalence of vertebral fractures was 35?% (95?% confidence interval 30-0?%) among survivors and 51?% (44-8?%) amongst cases. After adjusting for age, gender, smoking status, pack years smoked, coronary and aortic calcium volume and pulmonary emphysema, the adjusted hazard ratio (HR) for vertebral fracture was 2.04 (1.43-.92). For each 10 HU decline in trabecular bone density, the adjusted HR was 1.08 (1.02-.15). Conclusions Vertebral fractures and bone density are independently associated with all-cause mortality. Key Points -Lung cancer screening chest computed tomography contains additional, potentially useful information. -Vertebral fractures and bone density are independently predictive of mortality. -This finding has implications for screening and management decisions.