Frailty and genetic risk predict fracture after lung transplantation
Published by Elsevier Inc..
Fractures negatively impact quality of life and survival. We hypothesized that recipient frailty score and genetic profile measured before transplant would predict risk of fracture after lung transplant. We conducted a retrospective cohort study of bone mineral density (BMD) and fracture among lung transplant recipients at a single center. The association between predictors and outcomes were assessed by multivariable time-dependent Cox models or regression analysis. Among the 284 participants, osteoporosis and fracture were highly prevalent. Approximately 59% of participants had posttransplant osteopenia, and 35% of participants developed at least 1 fracture. Low BMD was associated with a polygenic osteoporosis risk score, and the interaction between genetic score and BMD predicted fracture. Pretransplant frailty was associated with risk for spine and hip fracture, which were not associated with chronic lung allograft dysfunction or death. Chest fractures were the most frequent type of fracture and conferred a 2.2-fold increased risk of chronic lung allograft dysfunction or death (time-dependent P < .001). Pneumonia, pleural effusions, and acute rejection frequently occurred surrounding chest fracture. Pretransplant frailty and recipient genotype may aid clinical risk stratification for fracture after transplant. Fracture carries significant morbidity, underscoring the importance of surveillance and osteoporosis prevention.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 23(2023), 2 vom: 24. Feb., Seite 214-222 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Macrae, Trisha A [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.02.2023 Date Revised 17.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajt.2022.11.017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352062517 |
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| 100 | 1 | |a Macrae, Trisha A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Frailty and genetic risk predict fracture after lung transplantation |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Inc. | ||
| 520 | |a Fractures negatively impact quality of life and survival. We hypothesized that recipient frailty score and genetic profile measured before transplant would predict risk of fracture after lung transplant. We conducted a retrospective cohort study of bone mineral density (BMD) and fracture among lung transplant recipients at a single center. The association between predictors and outcomes were assessed by multivariable time-dependent Cox models or regression analysis. Among the 284 participants, osteoporosis and fracture were highly prevalent. Approximately 59% of participants had posttransplant osteopenia, and 35% of participants developed at least 1 fracture. Low BMD was associated with a polygenic osteoporosis risk score, and the interaction between genetic score and BMD predicted fracture. Pretransplant frailty was associated with risk for spine and hip fracture, which were not associated with chronic lung allograft dysfunction or death. Chest fractures were the most frequent type of fracture and conferred a 2.2-fold increased risk of chronic lung allograft dysfunction or death (time-dependent P < .001). Pneumonia, pleural effusions, and acute rejection frequently occurred surrounding chest fracture. Pretransplant frailty and recipient genotype may aid clinical risk stratification for fracture after transplant. Fracture carries significant morbidity, underscoring the importance of surveillance and osteoporosis prevention | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a bronchiolitis obliterans (BOS) | |
| 650 | 4 | |a clinical research/practice | |
| 650 | 4 | |a comorbidities | |
| 650 | 4 | |a endocrinology/diabetology | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a genetics | |
| 650 | 4 | |a lung transplantation/pulmonology | |
| 650 | 4 | |a patient survival | |
| 650 | 4 | |a translational research/science | |
| 700 | 1 | |a Lazo, Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Viduya, Judy |e verfasserin |4 aut | |
| 700 | 1 | |a Florez, Rebecca |e verfasserin |4 aut | |
| 700 | 1 | |a Dewey, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Singer, Jonathan P |e verfasserin |4 aut | |
| 700 | 1 | |a Hays, Steven R |e verfasserin |4 aut | |
| 700 | 1 | |a Golden, Jeffrey A |e verfasserin |4 aut | |
| 700 | 1 | |a Kukreja, Jasleen |e verfasserin |4 aut | |
| 700 | 1 | |a Greenland, John R |e verfasserin |4 aut | |
| 700 | 1 | |a Calabrese, Daniel R |e verfasserin |4 aut | |
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