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Osteoporosis and fracture after gastrectomy for stomach cancer: A nationwide claims study.

Abstract This study was planned to evaluate the incidence and risk factors of osteoporosis and fracture after gastrectomy for stomach cancer using a nationwide claims database in South Korea.Data from 41,512 patients (50-79 years) who underwent gastrectomy for stomach cancer from 2008 to 2010 with at least 5 years of follow-up were obtained from the Health Insurance Review and Assessment Service database. Patients diagnosed with osteoporosis and prescribed bisphosphonate or raloxifene or who experienced osteoporotic fractures after gastrectomy were operationally defined as osteoporosis. Osteoporotic fracture was defined as a fracture at common osteoporotic fracture sites (spine, pelvis, hip, forearm, or rib).In total, 37,076 patients were included in the final analysis. The incidences of postgastrectomy osteoporosis and osteoporotic fractures were 41.9 and 27.6 cases per 1000 person-years, respectively. Multivariate analysis showed that older age (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.79-1.96), female gender (HR 2.46; 2.35-2.58), total gastrectomy (HR 1.10; 1.04-1.16), and diabetes (HR 1.16; 1.11-1.22) were significantly associated with osteoporosis and that older age (HR 1.90; 95% CI 1.80-2.01), female gender (HR 1.50; 1.41-1.58), total gastrectomy (HR 1.17; 1.10-1.25), chemotherapy (HR 1.06; 1.00-1.12), and diabetes (HR 1.26; 1.19-1.33) were significantly associated with fractures. Osteoporotic fractures occurred a median 3.1 years after gastrectomy. Among the 5175 fracture patients, 780 (15.1%) experienced multisite fractures, mostly in the elderly and chemotherapy groups.The osteoporosis and osteoporotic fracture incidences are high in patients within a relatively short timeframe after gastrectomy for stomach cancer. Systematic management of osteoporosis is necessary after this surgery.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29703028
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180516
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 17
DP  - 2018 Apr
TI  - Osteoporosis and fracture after gastrectomy for stomach cancer: A nationwide
      claims study.
PG  - e0532
LID - 10.1097/MD.0000000000010532 [doi]
AB  - This study was planned to evaluate the incidence and risk factors of osteoporosis
      and fracture after gastrectomy for stomach cancer using a nationwide claims
      database in South Korea.Data from 41,512 patients (50-79 years) who underwent
      gastrectomy for stomach cancer from 2008 to 2010 with at least 5 years of
      follow-up were obtained from the Health Insurance Review and Assessment Service
      database. Patients diagnosed with osteoporosis and prescribed bisphosphonate or
      raloxifene or who experienced osteoporotic fractures after gastrectomy were
      operationally defined as osteoporosis. Osteoporotic fracture was defined as a
      fracture at common osteoporotic fracture sites (spine, pelvis, hip, forearm, or
      rib).In total, 37,076 patients were included in the final analysis. The
      incidences of postgastrectomy osteoporosis and osteoporotic fractures were 41.9
      and 27.6 cases per 1000 person-years, respectively. Multivariate analysis showed 
      that older age (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.79-1.96), 
      female gender (HR 2.46; 2.35-2.58), total gastrectomy (HR 1.10; 1.04-1.16), and
      diabetes (HR 1.16; 1.11-1.22) were significantly associated with osteoporosis and
      that older age (HR 1.90; 95% CI 1.80-2.01), female gender (HR 1.50; 1.41-1.58),
      total gastrectomy (HR 1.17; 1.10-1.25), chemotherapy (HR 1.06; 1.00-1.12), and
      diabetes (HR 1.26; 1.19-1.33) were significantly associated with fractures.
      Osteoporotic fractures occurred a median 3.1 years after gastrectomy. Among the
      5175 fracture patients, 780 (15.1%) experienced multisite fractures, mostly in
      the elderly and chemotherapy groups.The osteoporosis and osteoporotic fracture
      incidences are high in patients within a relatively short timeframe after
      gastrectomy for stomach cancer. Systematic management of osteoporosis is
      necessary after this surgery.
FAU - Seo, Gi Hyeon
AU  - Seo GH
AD  - Health Insurance Review and Assessment Service.
FAU - Kang, Hae Yeon
AU  - Kang HY
AD  - Department of Internal Medicine, Healthcare Research Institute, Seoul National
      University Hospital Healthcare System Gangnam Center.
FAU - Choe, Eun Kyung
AU  - Choe EK
AD  - Department of Surgery, Healthcare Research Institute, Seoul National University
      Hospital Healthcare System Gangnam Center, Seoul, South Korea.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Bone Density Conservation Agents)
SB  - AIM
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Bone Density Conservation Agents/therapeutic use
MH  - Diabetes Mellitus
MH  - Female
MH  - Gastrectomy/methods/*statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Insurance Claim Review
MH  - Male
MH  - Middle Aged
MH  - Osteoporosis/drug therapy/*epidemiology
MH  - Osteoporotic Fractures/*epidemiology
MH  - Republic of Korea/epidemiology
MH  - Risk Factors
MH  - Sex Factors
MH  - Stomach Neoplasms/*surgery
PMC - PMC5944502
EDAT- 2018/04/29 06:00
MHDA- 2018/05/15 06:00
CRDT- 2018/04/29 06:00
PHST- 2018/04/29 06:00 [entrez]
PHST- 2018/04/29 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
AID - 10.1097/MD.0000000000010532 [doi]
AID - 00005792-201804270-00060 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(17):e0532. doi: 10.1097/MD.0000000000010532.