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骨质疏松症相关椎体骨折的健康经济影响

Osteoporosis associated vertebral fractures-Health economic implications.

作者信息

Joestl Julian, Lang Nikolaus, Bukaty Adam, Tiefenboeck Thomas M, Platzer Patrick

机构信息

Department of Trauma Surgery, Medical University of Vienna, Austria.

Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Austria.

出版信息

PLoS One. 2017 May 22;12(5):e0178209. doi: 10.1371/journal.pone.0178209. eCollection 2017.

Abstract

INTRODUCTION

Osteoporosis-associated vertebral fractures represent an increasing clinical and public health problem, one with important socioeconomic effects within western countries. The purpose of this study was to analyse demographic, medical, gender and socioeconomic aspects of osteoporotic vertebral fractures of the thoracic or lumbar spine over a period of at least 10-years.

MATERIAL AND METHODS

Included for analysis were 694 patients who had suffered a vertebral fracture due to primary or secondary osteoporosis, and who were treated at our Level-I trauma center between 2000 and 2013. Collected data included demographic, medical and socioeconomic aspects.

RESULTS

Clinical results revealed that 669 patients (96%) were treated conservatively. The remaining 25 patients (4%) underwent surgical therapy: 4 were treated with vertebroplasty, 15 with kyphoplasty and 6 patients with posterior stabilization. The mean age was 75.6 years (range: 50-98), with the vast majority of patients being female (n = 515). A statistically significant demographic difference (i.e., increase) in fractures was observed between the age groups 60-69 and 70-79 (p = 0.041). Concerning socioeconomic aspects, statistical analysis showed that the number of sick leaves and the need for professional domestic help was higher in female patients. Concerning treatment costs, statistical analysis did not reveal any significant differences between female and male patients.

CONCLUSION

Significant gender differences-to the detriment of the female population-could be demonstrated within this study. A regrettably low rate of adequate treatment after diagnosis of osteoporosis and its associated fractures-specifically relating to primary and secondary prevention-could also be identified. To prospectively avoid complications and consequential cost increases, more awareness of the necessity for prevention, early diagnosis and adequate treatment of osteoporosis and its related fractures should be considered.

摘要

引言

骨质疏松相关的椎体骨折是一个日益严重的临床和公共卫生问题,在西方国家具有重要的社会经济影响。本研究的目的是分析至少10年间胸腰椎骨质疏松性椎体骨折的人口统计学、医学、性别和社会经济方面的情况。

材料与方法

纳入分析的694例患者因原发性或继发性骨质疏松导致椎体骨折,并于2000年至2013年在我们的一级创伤中心接受治疗。收集的数据包括人口统计学、医学和社会经济方面的信息。

结果

临床结果显示,669例患者(96%)接受了保守治疗。其余25例患者(4%)接受了手术治疗:4例行椎体成形术,15例行后凸成形术,6例行后路内固定术。平均年龄为75.6岁(范围:50 - 98岁),绝大多数患者为女性(n = 515)。在60 - 69岁和70 - 79岁年龄组之间观察到骨折存在统计学显著差异(即增加)(p = 0.041)。在社会经济方面,统计分析表明女性患者的病假天数和需要专业家政帮助的需求更高。关于治疗费用,统计分析未显示女性和男性患者之间有任何显著差异。

结论

本研究显示了显著的性别差异——对女性群体不利。令人遗憾的是,还发现骨质疏松症及其相关骨折诊断后适当治疗的比例较低,特别是在一级和二级预防方面。为前瞻性地避免并发症和随之而来的成本增加,应考虑提高对骨质疏松症及其相关骨折预防、早期诊断和适当治疗必要性的认识。

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