Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Osteoporosis International
Published in: Osteoporosis International 5/2007

01-05-2007 | Original Article

Hospitalised osteoporotic vertebral fractures in Spain: Analysis of the national hospital discharge registry

Authors: C. Bouza, T. López, M. Palma, J. M. Amate

Published in: Osteoporosis International | Issue 5/2007

Login to get access

Abstract

Summary

This population-based study reveals clinical and epidemiologic characteristics of hospitalised osteoporosis-related vertebral fractures and indicates an association with a substantial hospital burden in Spain. These data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.

Introduction

Vertebral fractures (VF) are recognised as the most frequent complication of osteoporosis. Our objective was to determine the clinico-epidemiological characteristics and health-care burden of hospitalised VF in Spain.

Method

From the 2002 National Hospital Discharge Register, records for all osteoporosis-related VF in the Spanish population aged ≥30 years and over were retrieved. Diagnostic categories included the ICD-9-CM codes 805 and 733.xx. Population data were drawn from the National Statistics Institute.

Results

In total, 7,100 records were eligible for analysis. According to Deyo-adapted Charlson index, 62% of cases had no associated comorbidity. VF were the cause of hospitalisation in 52% of cases. Overall in-hospital mortality was 3.5%. Men had higher adjusted mortality than women. Mean hospital stay was 11.4±0.2 days. Identified cases amounted to a hospitalisation rate of 2.76 cases per 10,000 population aged ≥30 years. Direct inpatient hospital costs exceeded €41million and accounted for 0.078% of Spanish expenditure on hospitalisations and specialised care in 2002.

Conclusions

The national discharge database reveals epidemiological features of hospitalised osteoporosis-attributable VF and indicates an association with a substantial hospital burden in Spain. Our data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.
Literature
1.
2.
Cooper C, Melton LJ III (1992) Vertebral fractures: how large is the silent epidemic? BMJ 304:793–794PubMedCrossRef
3.
The European Prospective Osteoporosis Study (EPOS) Group (2002) Incidence of vertebral fracture in Europe: results from the European Prospective Osteoporosis Study (EPOS) J Bone Miner Res 17:716–724CrossRef
4.
Naves Diaz M, Diaz Lopez JB, Gomez Alonso C et al (2000) Study of incidence of osteoporotic fractures in a cohort of individuals older than 50 years from Asturias, Spain, after a 6 year follow-up period. Med Clin 115:650–653
5.
6.
Kado DM, Browner WS, Palermo L et al (1999) Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med 159:1215–1220PubMedCrossRef
7.
Cooper C, Atkinson EJ, Jacobsen SJ et al (1993) Population based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed
8.
Naves M, Diaz-Lopez JB, Gomez C et al (2003) The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporos Int 14:520–524PubMedCrossRef
9.
Cockerill W, Lunt M, Silman AJ et al (2004) Health-related quality of life and radiographic vertebral fracture. Osteoporos Int 15:113–119PubMedCrossRef
10.
O’Neill TW, Cockerill W, Matthis C et al (2004) Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int 15:760–765PubMedCrossRef
11.
Melton LJ 3rd, Thamer M, Ray NF et al (1997) Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation. J Bone Miner Res 12:16–23PubMedCrossRef
12.
Gehlbach SH, Bigelow C, Heimisdottir M et al (2000) Recognition of vertebral fractures in a clinical setting. Osteoporos Int 11:577–582PubMedCrossRef
13.
Jacobsen SJ, Cooper C, Gottlieb MS et al (1992) Hospitalization with vertebral fracture among the aged: a national population based study, 1986–1989. Epidemiology 3:515–518PubMed
14.
Johnell O, Gullberg B, Kanis JA (1997) The hospital burden of vertebral fracture in Europe: a study of National Register Sources. Osteoporos Int 7:138–144PubMedCrossRef
15.
Johnell O (2003) Economic implication of osteoporotic spine disease: cost to society. Eur Spine J 12:S168–S169PubMedCrossRef
16.
Lippuner K, Golder M, Greiner R (2005) Epidemiology and direct medical costs of osteoporotic fractures in men and women in Switzerland. Osteoporos Int 16:S8–S17PubMedCrossRef
17.
Puffer S, Torgerson DJ, Sykes D et al (2004) Health care costs of women with symptomatic vertebral fractures. Bone 35:383–386PubMedCrossRef
18.
Johnell O, Kanis JA, Jonsson B et al (2005) The burden of hospitalised fractures in Sweden. Osteoporos Int 16:222–228PubMedCrossRef
19.
Roos LL, Fedson DS, Roberts JD et al (1996) Reminding and monitoring: new uses of administrative data for preventive care. Health Manage Forum 9:30–36CrossRef
20.
Robinson JR, Young TK, Roos LL et al (1997) Estimating the burden of disease. Comparing administrative data and self-reports. Med Care 35:932–947PubMedCrossRef
21.
Charlson ME, Pompei P, Ales S et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383PubMedCrossRef
22.
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
23.
Librero J, Peiró S, Ordiñana R (1999) Chronic comorbidity and outcomes of hospital care: length of stay, mortality and readmission at 30 and 365 days. J Clin Epidemiol 52:171–179PubMedCrossRef
24.
25.
Papaioannou A, Watts NB, Kendler DL et al (2002) Diagnosis and management of vertebral fractures in elderly adults. Am J Med 113:220–228PubMedCrossRef
26.
27.
Vestergaard P, Rejnmark L, Mosekilde L (2005) Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16:134–141PubMedCrossRef
28.
Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456PubMedCrossRef
29.
Delmas PD, van de Langerijt L, Watts NB et al (2005) Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 20:557–563PubMedCrossRef
30.
Jalava T, Sarna S, Pylkkanen L et al (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1259PubMedCrossRef
31.
Ensrud KE, Thompson DE, Cauley JA et al (2000) Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J Am Geriatr Soc 48:241–249PubMed
32.
Kanis JA, Oden A, Johnell O et al (2004) Excess mortality after hospitalisation for vertebral fractures. Osteoporos Int 15:108–112PubMedCrossRef
33.
Papaioannou A, Adachi JD, Parkinson W et al (2001) Lengthy hospitalization associated with vertebral fractures despite control for comorbid conditions. Osteoporos Int 12:870–874PubMedCrossRef
34.
35.
Kanis JA, Johnell O, Oden A et al (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15:20–26PubMedCrossRef
36.
Ray NF, Chan JK, Thamer M et al (1997) Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 12:24–35PubMedCrossRef
37.
Gabriel SE, Tosteson AN, Leibson CL et al (2002) Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 13:323–330PubMedCrossRef
38.
Borgstrom F, Zethraeus N, Johnell O et al (2006) Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 17:637–650PubMedCrossRef
39.
Schwenkglenks M, Lippuner K, Hauselmann HJ et al (2005) A model of osteoporosis impact in Switzerland 2000–2020. Osteoporos Int 16:659–671PubMedCrossRef
40.
Ley Orgánica 15/1999 de 13 de Diciembre de Protección de Datos de Carácter personal. Boletín Oficial del Estado n° 298, de 14-12-1999, pp 43088–43099
41.
Ley 41/2002, de 14 noviembre, ley básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. Boletín Oficial del Estado n° 274, de 15-11-2002, pp 40126–40132. Accessible at http://​www.​msc.​es
42.
Wilchesky M, Tamblyn RM, Huang A (2004) Validation of diagnostic codes within medical services claims. J Clin Epidemiol 57:131–141PubMedCrossRef
43.
Delmas PD, Genant HK, Crans GG et al (2003) Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 33:522–532PubMedCrossRef
44.
O’Neill TW, Marsden D, Matthis C et al (1995) Survey response rates: national and regional differences in a European multicentre study of vertebral osteoporosis. J Epidemiol Community Health 49:87–93PubMedCrossRef
Metadata
Title
Hospitalised osteoporotic vertebral fractures in Spain: Analysis of the national hospital discharge registry
Authors
C. Bouza
T. López
M. Palma
J. M. Amate
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 5/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0292-x

Other articles of this Issue 5/2007

Osteoporosis International 5/2007 Go to the issue

Short Communication

Assessment of osteoclast number and function: application in the development of new and improved treatment modalities for bone diseases

Original Article

Modulation of soy isoflavones bioavailability and subsequent effects on bone health in ovariectomized rats: the case for equol

Original Article

Trends in hospital care for hip fractures

Letter

Comment on Schott et al.: Which screening strategy using BMD measurements would be most cost effective for hip fracture prevention in elderly women? A decision analysis based on a Markov model

Letter to the Editor

Reply to Fisher et al.: Calcium-PTH-vitamin D axis in older patients with hip fracture

Original Article

Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound