Loss of bone mineral density following sepsis using Hounsfield units by computed tomography

To examine the change in vertebral bone mineral density (BMD) using abdominal computed tomography in patients treated for sepsis.

A single-center, retrospective, observational study was undertaken to evaluate BMD after critical care at Okayama Saiseikai General Hospital (Okayama, Japan) from January 2016 to April 2018. Sepsis was defined as an absolute increase of ≥2 in Sequential Organ Failure Assessment score in the intensive care unit or high care unit. Bone mineral density was evaluated in Hounsfield units (HU) by computed tomography. Patients were divided into groups based on the presence or absence of osteoporosis, which was defined as average vertebral body HU <110. Paired t-tests were used to compare the mean BMD of each vertebra between before and after critical care. We also analyzed accidental bone fracture events after discharge. The survival rate was analyzed as an outcome using the Kaplan-Meier method.

Fifty-two of 188 patients met the inclusion criteria. We found significant differences between admission and follow-up vertebral BMD values in the spine at the thoracic 12, lumbar 1-5, and sacrum 1 levels (P < 0.05), especially in the non-osteoporosis groups. No difference in mortality was observed between patients with osteoporosis and those without. Two of 19 patients with osteoporosis developed a bone fracture.

We found that sepsis was associated with loss in BMD following critical care.