Incidence of Fractures after Cardiac and Lung Transplantation: A Single Center Experience

Table 1

Comparison of those with fractures versus no fractures in the lung transplant population.

	Fracture 𝑛=17	Nonfracture 𝑛=193	Test statistic (df)	𝑃
Demographics
Mdn age (years) (IQR)	58 (50–59); 𝑛=17	56 (49–62); 𝑛=192	1772.5 (209)^1	.96
Mdn BMI (IQR)	23.65 (21.51–25.35); 𝑛=16	25.01 (20.97–27.35); 𝑛=187	1381.00 (203)^1	.27
Females	8/17 (47%)	92/192 (48%)	0.005 (1)^2	.95
Menopause	1/8 (13%)	32/91 (35%)	1.70 (1)^3	.26
Ex-smokers	13/17 (77%)	127/192 (66%)	0.75 (1)^2	.39
Pretransplant fracture	0/16 (0%)	11/192 (6%)	0.97 (1)^3	.99
Reason for transplantation
Chronic obstructive pulmonary disease	8/17 (47%)	60/193 (31%)	2.04 (2)^2	.36
Idiopathic pulmonary fibrosis	5/17 (29%)	64/193 (33%)
Other	4/17 (24%)	69/193 (36%)
Pretransplant values
Mdn LS T score (IQR)	−1.60 (−2.40–0.10); 𝑛=13	−1.00 (−2.00–0.10); 𝑛=131	791.50 (144)^1	.29
Mdn femoral neck T score (IQR)	−2.40 (−2.70–−1.80); 𝑛=13	−1.50 (−2.10–−0.60); 𝑛=134	678.00 (147)^1	.053
Mdn serum calcium (mg/dL) (IQR)	8.30 (7.80–8.80); 𝑛=17	8.20 (7.80–9.00); 𝑛=191	1740.50 (208)^1	.88
Mdn serum phosphorus (mg/dL) (IQR)	3.15 (2.3–3.9); 𝑛=8	3.60 (3.10–4.20); 𝑛=93	292.00 (101)^1	.15
Mean serum albumin (gm/dL) (SD)	2.80 (0.45); 𝑛=14	2.62 (0.60); 𝑛=138	−1.11 (150)^4	.27
Mdn serum bone-specific alk. phosphatase (mcg/L) (IQR)	—	10.10 (9.40–13.10); 𝑛=13	—	—
Mdn serum parathyroid hormone (pg/mL) (IQR)	50.00 (41.00–53.00); 𝑛=5	41.00 (30.00–65.00); 𝑛=87	277.00 (92)^1	.45
Mdn serum vitamin D 25-OH (ng/mL) (IQR)	29.00 (20.00–38.00); 𝑛=2	28.50 (18.50–37.00); 𝑛=56	64.00 (58)^1	.85
Mdn serum creatinine (mg/dL) (IQR)	0.73 (0.60–0.94); 𝑛=17	0.81 (0.70–1.00); 𝑛=192	1511.00 (209)^1	.25
Posttransplant medications
Bisphosphonate	9/17 (53%)	95/192 (50%)	0.08 (1)^2	.78
Calcium and vitamin D	16/17 (94%)	165/183 (90%)	0.28 (1)^3	.99
Glucocorticoid	17/17 (100%)	175/193 (91%)	1.73 (1)^3	.37
Posttransplant values
Mdn LS T score (IQR)	−1.50 (−2.40–−0.25); 𝑛=12	−1.00 (−2.00–0.00); 𝑛=98	556.00 (110)^1	.29
Mdn femoral neck T score (IQR)	−2.75 (−3.32–−2.0); 𝑛=12	−1.60 (−2.43–−1.00); 𝑛=98	376.00 (110)^1	.01
Mdn serum calcium (mg/dL) (IQR)	8.90 (8.50–9.10); 𝑛=17	8.80 (8.50–9.20); 𝑛=188	1713.00 (205)^1	.87
Mdn serum phosphorus (mg/dL) (IQR)	3.05 (2.40–3.90); 𝑛=10	3.80 (3.30–4.50); 𝑛=102	372.50 (112)^1	.049
Mdn serum albumin (gm/dL) (IQR)	2.90 (2.60–3.30); 𝑛=11	3.10 (2.70–3.40); 𝑛=123	655.50 (134)^1	.48
Mdn serum bone-specific alk. phosphatase (mcg/L) (IQR)	10.20 (8.95–17.40); 𝑛=4	8.85 (6.40–12.90); 𝑛=50	140.50 (54)^1	.33
Mdn serum parathyroid hormone (pg/mL) (IQR)	47.00 (39.00–53.00); 𝑛=11	59.50 (33.50–88.50); 𝑛=104	479.00 (115)^1	.13
Mdn serum vitamin D 25-OH (ng/mL) (IQR)	22.00 (21.00–33.00); 𝑛=13	25.00 (17.00–35.00); 𝑛=138	1,031.00 (151)^1	.78
Mdn serum creatinine (mg/dL) (IQR)	1.00 (0.90–1.10); 𝑛=17	0.94 (0.80–1.20); 𝑛=190	1641.50 (207)^1	.59

Note: Mdn: median, IQR: interquartile range, SD: standard deviation, and df: degrees of freedom for the test statistic (i.e., ¹Wilcoxon rank sum test due to nonnormality or low sample size in the fracture cohort; ²Pearson’s chi-square statistic; ³Fisher’s exact test due to low expected frequencies; and ⁴independent 𝑡-test with observed normality and homogeneity). Percentages are within column.