Osteoporosis in patients referred for lung transplantation

Jastrzębski, Dariusz; Lutogniewska, W; Ochman, Marek; Margas, A; Kowalski, Kamil; Wyrwol, J; Ksiazek, B; Wojarski, Jacek; Żegleń, Sławomir; Ziora, Dariusz; Kozielski, Jerzy

doi:10.1186/2047-783x-15-s2-68

Cited by 28 publications

(8 citation statements)

References 6 publications

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“…The participants for most studies were predominantly male, excepting for five studies [31][32][33][34][35][36][37]. A high proportion of studies (92%) had participants whose mean age was ⩾60 years with the exception of 10 studies [33,34,[38][39][40][41][42][43][44][45]. The remaining studies did not report the age of the participants.…”

Section: Participant Characteristicsmentioning

confidence: 99%

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Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

et al. 2020

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Idiopathic pulmonary fibrosis (IPF) is one of the most common forms of interstitial lung disease presenting in persons 50 years and older. Through a comprehensive review of available studies, we aimed to assess health-related quality of life (HRQoL) of people living with IPF and the instruments used in this assessment.Searches were conducted up to May, 2020. Quality appraisal and data extraction were performed using pre-designed forms. Narrative synthesis approach was used to report results of the systematic review and a random effects model was used for the meta-analysis. A leave-one-out sensitivity analysis was performed, and a trim and fill method was used to assess publication bias.The review included 134 studies. The most used instruments to measure HRQoL were St George's Respiratory Questionnaire (SGRQ), Short Form 36 (SF36) and EuroQoL (EQ5D). Standardised mean scores (95% confidence interval) for these instruments were as follows: SGRQ total score: 44.72 (42.21–47.22); SF36 physical component score (PCS): 37.00 (34.74–39.26) SF36 mental component score (MCS): 50.18 (48.41–51.95); King's Brief Interstitial Lung Disease questionnaire total score: 58.38 (55.26–61.51); and EQ5D utility: 0.73 (0.68–0.79). Analysis of standardised means for both SGRQ and SF36 demonstrated worse scores in physical health domains as compared to mental health domains.This systematic review confirms that IPF negatively affected HRQoL, mostly impacting the physical health domains. This study also demonstrated that a diverse number of instruments are used to evaluate HRQoL. In view of this diversity, a standardised approach to measurement of HRQoL for IPF is important to ensure that comparisons made are reliable.

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Section: Participant Characteristicsmentioning

confidence: 99%

“…With reference to disease severity [18][19][20], 51% of studies reported on participants with moderate disease severity, 37% were on participants with mild disease while only 4% of studies included participants with severe disease [33,[40][41][42]55] (table 1 and supplementary material S8).…”

Section: Clinical Diagnosis and Stagingmentioning

confidence: 99%

Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

et al. 2020

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“…25-50 Of those, 20 studies showed a significant relationship with mortality on the waiting list, with the vast majority (14 studies) using a hazard ratio to calculate mortality risk with the 6MWT distance (6MWD). 25-44 Seven studies examined the relationship of the 6MWT with mortality or survival posttransplant‚ 14,27,30,47,51-53 with 3 studies showing that a lower 6MWD is associated with this outcome. 27,51,52 Five studies examined the relationship of the 6MWT with QOL, 46,54-57 with 3 studies showing some relationship with QOL pretransplant.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-six studies examined the relationship of the 6MWT with mortality or survival on the waiting list. 25-50 Of those, 20 studies showed a significant relationship with mortality on the waiting list, with the vast majority (14 studies) using a hazard ratio to calculate mortality risk with the 6MWT distance (6MWD). 25-44 Seven studies examined the relationship of the 6MWT with mortality or survival posttransplant‚ 14,27,30,47,51-53 with 3 studies showing that a lower 6MWD is associated with this outcome.…”

Section: Resultsmentioning

confidence: 99%

Relationship of Exercise Capacity, Physical Function, and Frailty Measures With Clinical Outcomes and Healthcare Utilization in Lung Transplantation: A Scoping Review

Bourgeois

Shallwani

Al-Huda

et al. 2022

Transplantation Direct

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Background. Measures of exercise capacity, frailty, and physical function are commonly used in lung transplant candidates and recipients to evaluate their physical limitations and the effects of exercise training and to select candidates for transplantation. It is unclear how these measures are related to clinical outcomes and healthcare utilization before and after lung transplantation. The purpose of this scoping review was to describe how measures of exercise capacity, physical function, and frailty are related to pre- and posttransplant outcomes. Methods. We considered studies of any design that included performance-based tests of exercise capacity, physical function, and frailty in adult lung transplant candidates or recipients. Outcomes of interest were clinical outcomes (eg, mortality, quality of life) and healthcare utilization. Results. Seventy-two articles met the inclusion criteria. The 6-min walk test (6MWT) was shown to be related to mortality on the waiting list with different distance values as cutoffs points. There were inconsistent results regarding the relationship of the 6MWT with other clinical outcomes. Few studies have examined the relationship between the cardiopulmonary exercise test or the short physical performance battery and clinical outcomes, although some studies have shown relationship with survival posttransplant and quality of life. Few studies examined the relationship between the tests of interest and healthcare utilization‚ and the results were inconsistent. Conclusions. Except for the relationship between the 6MWT and mortality on the waiting list, there is limited evidence regarding the relationship of performance-based measures of exercise capacity, frailty, and physical function with clinical outcomes or healthcare utilization.

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“…In der 6–18 monatigen Nachbeobachtungsphase erhöhte sich diese Prävalenz auf über 50 % [ 56 ]. Mehr als 60 % der PatientInnen mit end-stage Lungenerkrankungen haben eine herabgesetzte Knochendichte [ 57 , 58 ]. Risikofaktoren für einen Knochenverlust vor der Transplantation sind Alter, die Diagnose COPD, intermittierende oder kontinuierliche Steroidtherapie, Nikotinabusus, sowie Verlust an Körpergewicht und Muskelmasse (pulmonale Kachexie) durch zunehmende körperliche Dekonditionierung [ 59 ].…”

Section: Frakturrisiko Bei Lungentransplantationunclassified

Osteoporose bei pneumologischen Erkrankungen

Muschitz

Zwick²,

Haschka

et al. 2021

Wien Klin Wochenschr

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ZusammenfassungAsthma und COPD sind die häufigsten obstruktiven Atemwegserkrankungen. Die chronische Inflammation bedingt eine Induktion von proinflammatorischen Zytokinkaskaden. Neben der systemischen Inflammation tragen Hypoxämie, Hyperkapnie, eine katabole Stoffwechsellage, eine gonadale oder eine Schilddrüsendysfunktion, eine muskuloskelettale Dysfunktion und Inaktivität sowie Vitamin D‑Mangel zu einem erhöhten Knochenbruchrisiko bei. Iatrogene Ursachen der Osteoporose sind die zum Teil langjährigen Anwendungen von inhalativen oder systemischen Glukokortikoiden (GC). Die inhalative GC Applikation bei Asthma ist oft schon im Kindes- und Jugendalter indiziert, aber auch interstitielle Lungenerkrankungen wie die chronisch organisierende Pneumonie, die Sarkoidose oder rheumatische Erkrankungen mit Lungenbeteiligung werden mit inhalativen oder oralen GC behandelt. Bei PatientInnen mit zystischer Fibrose kommt es durch die Malabsorption im Rahmen der Pankreasinsuffizienz, durch Hypogonadismus und chronische Inflammation mit erhöhter Knochenresorption zu einer Abnahme der Knochenstruktur. Nach Lungentransplantation ist die Immunsuppression mit GC ein Risikofaktor.Die pneumologischen Grunderkrankungen führen zu einer Veränderung der trabekulären und kortikalen Mikroarchitektur des Knochens und zu einer Verminderung von osteologischen Formations- und Resorptionsmarkern. Hyperkapnie, Azidose und Vitamin D‑Mangel können diesen Prozess beschleunigen und somit das individuelle Risiko für osteoporotische Fragilitätsfrakturen erhöhen.Eine Knochendichtemessung mit einem T‑Score < −2,5 ist ein Schwellenwert zur Diagnose der Osteoporose, die überwiegende Mehrzahl aller osteoporotischen Frakturen tritt bei einem T‑Score von > −2,5 auf. Eine niedrig-traumatische Fraktur in der Anamnese indiziert eine osteologische Therapie.Neben der Optimierung des Vitamin D‑Spiegels sind sämtliche in Österreich zur Behandlung der Osteoporose zugelassenen antiresorptiv oder anabol wirksamen Medikamente auch bei pneumologischen PatientInnen mit einem erhöhten Knochenbruchrisiko entsprechend der nationalen Erstattungskriterien indiziert.

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Osteoporosis in patients referred for lung transplantation

Cited by 28 publications

References 6 publications

Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Relationship of Exercise Capacity, Physical Function, and Frailty Measures With Clinical Outcomes and Healthcare Utilization in Lung Transplantation: A Scoping Review

Osteoporose bei pneumologischen Erkrankungen

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