在例行放射性影像检查中机会性识别的脊椎骨折预测死亡率:观察性队列研究
Michael Kriegbaum Skjødt1,2, Joeri Nicolaes3,4, Christopher Dyer Smith5
1Department of Medicine, Holbæk Hospital, Holbæk, Denmark. miksk@regionsjaelland.dk.
概括
在常规CT扫描中检测到的脊椎骨折 (VFs) 的男性和女性死亡风险明显更高. 早期识别VF对于及时干预和改善患者结果至关重要.
科学领域:
- 放射学和成像学 放射学和成像学
- 流行病学 流行病学
- 老年学是一门学科.
背景情况:
- 脊椎骨折 (VFs) 很常见,特别是在老年人中.
- 在常规CT扫描中偶然检测到的VF的预后影响尚未得到充分理解.
- 需要评估与非骨成像期间发现的VF相关的死亡风险.
研究的目的:
- 评估50岁及以上,在常规计算机断层扫描 (CT) 扫描中偶尔发现的脊椎骨折 (VFs) 患者的死亡风险.
- 在CT扫描中比较VF和无VF患者之间的死亡率.
- 为了比较患有VF的患者的死亡率与匹配的一般人口队列.
主要方法:
- 一个回顾性队列研究使用CT扫描从2010年起在丹麦一家医院进行.
- 脊椎骨折 (VFs) 使用盲目的两步方法来确定.
- 患有VF的受试者与没有VF的受试者相匹配1:2,与普通人群相匹配1:3,并进行长达7年的跟踪.
主要成果:
- 在CT扫描中出现VF的个体与没有VF的个体相比,死亡风险高出51% (调整后危险比率[HR]1.51).
- 与一般人群相比,死亡风险明显高 (HR 4.25).
- 增加的死亡风险与中度/严重的风险相关,没有先前的恶性病变,并较低的并发症得分.
结论:
- 在常规CT扫描中检测到的偶然的脊椎骨折 (VFs) 与死亡风险显著增加有关.
- 机会性识别和报告VF对于识别有风险的患者至关重要.
- 对已识别的VF进行快速干预可能有必要,以减轻死亡风险.
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