Abstract :
[en] Clinical consequences of critical illness and
critical care (CC) on bone health remain largely unexplored.
This retrospective study aimed to assess the number
of new bone fractures (BF) following a prolonged length of
stay (LOS) in intensive care unit (ICU). Adults admitted in
our tertiary ICU during 2013 with a stay [7 days were
included (CC group). Patients who died in ICU or lost to
follow-up were excluded. For each CC patient still alive
after 2 years of follow-up, 2 control patients, scheduled for
surgery during 2013, were recruited and matched for gender
and age. Basal fracture risk before admission was
calculated using FRAX tool. General practitioners were
phoned to check out new bone fracture (BF) during 2 years
after admission. Of the 457 enrolled CC patients, 207 did
not meet inclusion criteria and 72 died during FU (median
age 72 [65–77] years). New BF occurred in 9 of the 178
patients still alive at the end of FU (5%). Median age of
these patients was 64 [53–73] years. Fractured patients did
not differ from non-fractured ones based on demographic
and clinical characteristics, excepting for FRAX risks that
were higher in fractured patients. In the control group, 327
patients were analyzed. Their rate of BF was 3.4% without
statistical significance compared to the CC group. FRAX
risks were similar in both groups. The risk of new BF in CC
group, expressed as an odds ratio, was 50% higher than in
the control group without achieving statistical significance
(odds ratio 1.53; 95% confidence interval 0.62–3.77;
p = 0.35). When comparing ICU survivors to patients who
underwent uncomplicated surgery in the present preliminary
study included limited cohorts, the fracture risk in the
2 years following prolonged ICU stay was not statistically
higher. However, CC fractured patients had higher FRAX
risks than non-fractured patients. Such screening could
help to target prevention and appropriate treatment
strategies.
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