Details

Autor(en) / Beteiligte

• Oppl, Bastian
• Michitsch, Gabriele
• Misof, Barbara
• Kudlacek, Stefan
• Donis, Johann
• Klaushofer, Klaus
• Zwerina, Jochen
• Zwettler, Elisabeth

Titel

Low Bone Mineral Density and Fragility Fractures in Permanent Vegetative State Patients

Ist Teil von

• Journal of bone and mineral research, 2014-05, Vol.29 (5), p.1096-1100

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• ABSTRACT Disuse of the musculoskeletal system causes bone loss. Whether patients in vegetative state, a dramatic example of immobilization after severe brain injury, suffer from bone loss and fractures is currently unknown. Serum markers of bone turnover, bone mineral density (BMD) measurements, and clinical data were cross‐sectionally analyzed in 30 consecutive vegetative state patients of a dedicated apallic care unit between 2003 and 2007 and compared with age‐ and sex‐matched healthy individuals. Vegetative state patients showed low calcium levels and vitamin D deficiency compared with healthy controls. Serum bone turnover markers revealed high turnover as evidenced by markedly elevated carboxy‐terminal telopeptide of type I collagen (β‐crosslaps) and increased levels of alkaline phosphatase. BMD measured by dual‐energy X‐ray absorptiometry (DXA) scanning showed strongly decreased T‐ and Z‐scores for hip and spine. Over a period of 5 years, 8 fragility fractures occurred at peripheral sites in 6 of 30 patients (n = 3 femur, n = 2 tibia, n = 2 fibula, n = 1 humerus). In conclusion, high bone turnover and low BMD is highly prevalent in vegetative state patients, translating into a clinically relevant problem as shown by fragility fractures in 20% of patients over a time period of 5 years. © 2014 American Society for Bone and Mineral Research.