Scholarlink

Summary <p>Splenectomy compromises bone health by disrupting the immune–bone axis. In this nationwide cohort study, splenectomy was associated with increased risk of fractures, particularly hip fractures, with the strongest association observed after traumatic splenectomy. These findings support the need for bone quality monitoring and preventive strategies in post-splenectomy patients.</p> Background <p>Splenectomy may interfere with immune-mediated bone remodeling, potentially compromising bone quality and strength. However, large-scale, long-term evidence linking splenectomy to bone health remains limited. We aimed to investigate the association between splenectomy and fracture incidence using a nationwide cohort.</p> Methods <p>The analysis included 3,125,549 individuals who participated in national health screenings conducted by the Korean National Health Insurance Service, of which 769 had undergone splenectomy. The primary outcome was the incidence of new-onset fractures (hip, vertebral, or other fractures). Multivariable Cox proportional hazards models were used to assess fracture risk, adjusting for potential confounders.</p> Results <p>Over a median follow-up of 10.3&#xa0;years, the splenectomy group exhibited a significantly increased risk for any fracture (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.33–1.95), hip fracture (HR 2.57, 95% CI 1.76–3.76), and other fractures (HR 1.36, 95% CI 1.05–1.76). Although splenectomy was not significantly associated with vertebral fracture risk in the overall population, analyses stratified by the indication of splenectomy revealed a pronounced increase in risk among individuals who underwent traumatic splenectomy, with a 3.27-fold higher risk of vertebral fracture (95% CI 1.06–10.15) and a 7.86-fold higher risk of hip fractures (95% CI 2.95–20.95). Subgroup analyses identified significantly higher vertebral fracture risks among males and current drinkers.</p> Conclusion <p>Our findings indicate that splenectomy is associated with an increased risk of fractures, particularly hip fractures, with the association being most pronounced among individuals who underwent traumatic splenectomy. These findings highlight the necessity of individualized bone health monitoring and targeted preventive strategies for post-splenectomy patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of splenectomy on fracture risk via the bone-immune axis: A nationwide Korean cohort study

  • 期刊论文

  • 发表日期：

    2026年3月20日

查看全文
  • Seonghyun Kang,
  • Nak-Jun Choi,
  • Kyungdo Han,
  • Yebin Park,
  • Changsin Lee,
  • Sejong Jin,
  • Ga Eun Nam,
  • Jae-Woo Cho

摘要

Summary

Splenectomy compromises bone health by disrupting the immune–bone axis. In this nationwide cohort study, splenectomy was associated with increased risk of fractures, particularly hip fractures, with the strongest association observed after traumatic splenectomy. These findings support the need for bone quality monitoring and preventive strategies in post-splenectomy patients.

Background

Splenectomy may interfere with immune-mediated bone remodeling, potentially compromising bone quality and strength. However, large-scale, long-term evidence linking splenectomy to bone health remains limited. We aimed to investigate the association between splenectomy and fracture incidence using a nationwide cohort.

Methods

The analysis included 3,125,549 individuals who participated in national health screenings conducted by the Korean National Health Insurance Service, of which 769 had undergone splenectomy. The primary outcome was the incidence of new-onset fractures (hip, vertebral, or other fractures). Multivariable Cox proportional hazards models were used to assess fracture risk, adjusting for potential confounders.

Results

Over a median follow-up of 10.3 years, the splenectomy group exhibited a significantly increased risk for any fracture (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.33–1.95), hip fracture (HR 2.57, 95% CI 1.76–3.76), and other fractures (HR 1.36, 95% CI 1.05–1.76). Although splenectomy was not significantly associated with vertebral fracture risk in the overall population, analyses stratified by the indication of splenectomy revealed a pronounced increase in risk among individuals who underwent traumatic splenectomy, with a 3.27-fold higher risk of vertebral fracture (95% CI 1.06–10.15) and a 7.86-fold higher risk of hip fractures (95% CI 2.95–20.95). Subgroup analyses identified significantly higher vertebral fracture risks among males and current drinkers.

Conclusion

Our findings indicate that splenectomy is associated with an increased risk of fractures, particularly hip fractures, with the association being most pronounced among individuals who underwent traumatic splenectomy. These findings highlight the necessity of individualized bone health monitoring and targeted preventive strategies for post-splenectomy patients.