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Association of sepsis with risk for osteoporosis: a population-based cohort study

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Abstract

Summary

We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database to evaluate whether the risk of developing osteoporosis is associated with sepsis. Our study found that adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis.

Introduction

There have been limited studies regarding the osteoporosis risk associated with sepsis. Our purpose is to evaluate whether the risk of developing osteoporosis is associated with sepsis.

Methods

We conducted a large, retrospective cohort study using data from Taiwan’s National Health Insurance Research Database. From the insurance claims data, a total of 13,178 patients diagnosed with sepsis from 2000 to 2012 were included in the sepsis cohort, and a propensity score-matched cohort included 13,178 individuals without sepsis. To calculate the incidence of osteoporosis, both groups were followed until 2013. Cox regression analysis was performed to obtain the hazard ratios (HRs) to assess the risk of developing osteoporosis. The Kaplan–Meier method was used to estimate the cumulative incidence of osteoporosis.

Results

The overall incidences of osteoporosis (per 1,000 person-years) in the sepsis and non-sepsis groups were 10.2 and 10.7, respectively. The risk of osteoporosis significantly increased in the presence of sepsis (adjusted HR = 1.17, 95% confidence interval (CI) = 1.04–1.31). The risk of osteoporosis in the sepsis group was significantly higher than that in the non-sepsis group for young patients aged 20–49 years and patients aged 50–64 years (adjusted HR = 1.93, 95% CI = 1.08–3.44; adjusted HR = 2.01, 95% CI = 1.52–2.65, respectively). The Kaplan–Meier curves of cumulative probability also showed a significantly increased risk of osteoporosis in patients aged 20–49 years and aged 50–64 years with sepsis compared with non-sepsis (P = 0.025; P < 0.001, respectively).

Conclusion

Adults younger than 65 years with sepsis had a significantly increased risk of developing osteoporosis.

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Author information

Author notes

  1. Y.-F. Lee and P.-Y. Leong contributed equally to this work.

Authors and Affiliations

  1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Y.-F. Lee & P.-Y. Leong

  2. Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan

    Y.-F. Lee

  3. Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan

    H.-K. Tsou

  4. Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan

    H.-K. Tsou

  5. Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan

    P.-Y. Leong

  6. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan

    Y.-H. Wang

  7. Department of Rheumatology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China

    J. C.-C. Wei

  8. Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    J. C.-C. Wei

  9. Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan

    J. C.-C. Wei

  10. Institute of Medicine, College of medicine, Chung Shan Medical University, Taichung, Taiwan

    J. C.-C. Wei

  11. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

    J. C.-C. Wei

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  1. Y.-F. Lee
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Correspondence to J. C.-C. Wei.

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Lee, YF., Tsou, HK., Leong, PY. et al. Association of sepsis with risk for osteoporosis: a population-based cohort study. Osteoporos Int 32, 301–309 (2021). https://doi.org/10.1007/s00198-020-05599-3

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