Top

Osteoporosis International

Published in:

01-02-2013 | Original Article

Life expectancy following diagnosis of a vertebral compression fracture

Authors: A. A. Edidin, K. L. Ong, E. Lau, S. M. Kurtz

Published in: Osteoporosis International | Issue 2/2013

Abstract

Summary

The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. Compared to non-operated patients, the kyphoplasty and vertebroplasty patient cohort had 115% and 44% greater adjusted life expectancy, respectively. Kyphoplasty patients had a 34% greater adjusted life expectancy than vertebroplasty patients.

Introduction

Balloon kyphoplasty and vertebroplasty are minimally invasive procedures for the treatment of painful VCFs. This comparative effectiveness study characterized the life expectancy of VCF patients as a function of their treatment.

Methods

Life expectancy of VCF patients in the 100% U.S. Medicare dataset (2005–2008) was estimated using a parametric Weibull survival model (adjusted for comorbidities), and compared between operated and non-operated patients as well as between kyphoplasty and vertebroplasty patients. A total of 858,978 patients with a newly diagnosed VCF were identified, including 119,253 kyphoplasty patients (13.9%) and 63,693 vertebroplasty patients (7.4%).

Results

Adjusted life expectancy was 85% greater for operated than non-operated patients (p < 0.001; 95% confidence interval: 82–89%). Compared to non-operated patients, the kyphoplasty and vertebroplasty patient cohort had 115% (p < 0.001; 95% confidence interval: 111–119%) and 44% (p < 0.001; 95% confidence interval: 42–47%) greater adjusted life expectancy, respectively. Kyphoplasty patients had a 34% greater adjusted life expectancy than vertebroplasty patients (p < 0.001; 95% confidence interval: 31–36%). Across all gender–age groups, the median life expectancy predicted by the parametric Weibull model was 2.2–7.3 years greater for operated than non-operated patients.

Conclusions

Statistically significant and substantial differences in life expectancy were observed between the treated and non-treated cohorts in the Medicare population. Among the treated cohorts, patients in the vertebroplasty group experienced less of a survival benefit than those who received kyphoplasty. The results will be a useful basis for future cost effectiveness studies of VCF treatments for the Medicare population.

Cooper C (2010) Osteoporosis: disease severity and consequent fracture management. Osteoporos Int 21(Suppl 2):S425–S429PubMedCrossRef

Cooper C, Atkinson EJ, Jacobsen SJ, O'Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed

Gill JB, Kuper M, Chin PC, Zhang Y, Schutt R Jr (2007) Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician 10:583–590PubMed

Buchbinder R, Osborne RH, Ebeling PR, Wark JD, Mitchell P, Wriedt C, Graves S, Staples MP, Murphy B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568PubMedCrossRef

Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579PubMedCrossRef

Klazen CA, Lohle PN, de Vries J, Jansen FH, Tielbeek AV, Blonk MC, Venmans A, van Rooij WJ, Schoemaker MC, Juttmann JR, Lo TH, Verhaar HJ, van der Graaf Y, van Everdingen KJ, Muller AF, Elgersma OE, Halkema DR, Fransen H, Janssens X, Buskens E, Mali WP (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 376:1085–1092

Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, Eastell R, Shabe P, Talmadge K, Boonen S (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024PubMedCrossRef

Edidin AA, Ong KL, Lau E, Kurtz SM (2011) Mortality risk for operated and non-operated vertebral fracture patients in the Medicare population. J Bone Miner Res, in review

Thorpe JH (2010) Comparative effectiveness research and health reform: implications for public health policy and practice. Public Health Rep 125:909–912PubMed

10.

Zampini JM, White AP, McGuire KJ (2010) Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty. Clin Orthop Relat Res 468:1773–1780PubMedCrossRef

11.

Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619PubMedCrossRef

12.

Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMedCrossRef

13.

Gaitatzis A, Johnson AL, Chadwick DW, Shorvon SD, Sander JW (2004) Life expectancy in people with newly diagnosed epilepsy. Brain 127:2427–2432PubMedCrossRef

14.

Puvimanasinghe JP, Takkenberg JJ, Eijkemans MJ, Steyerberg EW, van Herwerden LA, Grunkemeier GL, Habbema JD, Bogers AJ (2005) Prognosis after aortic valve replacement with the Carpentier–Edwards pericardial valve: use of microsimulation. Ann Thorac Surg 80:825–831PubMedCrossRef

15.

Strom O, Leonard C, Marsh D, Cooper C (2010) Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting. Osteoporos Int 21:1599–1608PubMedCrossRef

16.

(2010) 2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplemental Medical Insurance Trust Funds. Washington, D.C

17.

Mitka M (2010) US government kicks off program for comparative effectiveness research. JAMA 304:2230–2231PubMedCrossRef

18.

Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, Baron A, Griffing S, Holmgren E, Ferrara N, Fyfe G, Rogers B, Ross R, Kabbinavar F (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342PubMedCrossRef

19.

Al-Khatib SM, Anstrom KJ, Eisenstein EL, Peterson ED, Jollis JG, Mark DB, Li Y, O'Connor CM, Shaw LK, Califf RM (2005) Clinical and economic implications of the Multicenter Automatic Defibrillator Implantation Trial-II. Ann Intern Med 142:593–600PubMed

Title: Life expectancy following diagnosis of a vertebral compression fracture
Authors: A. A. Edidin
K. L. Ong
E. Lau
S. M. Kurtz
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 2/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-012-1965-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Life expectancy following diagnosis of a vertebral compression fracture

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2013

Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey

Assessing the risk of osteonecrosis of the jaw due to bisphosphonate therapy in the secondary prevention of osteoporotic fractures

MENOPOST - Calcium and vitamin D supplementation in postmenopausal osteoporosis treatment: a descriptive cohort study

Secular changes in Paget’s disease: contrasting changes in the number of new referrals and in disease severity in two neighboring regions of Spain

Does frequency of resistance training affect tibial cortical bone density in older women? A randomized controlled trial

Erratum to: SHBG levels are associated with bone loss and vertebral fractures in patients with prostate cancer