Zohar Ariel, Getzler Itamar, Behrbalk Eyal
Department of Orthopedics, Carmel Medical Center, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Geriatr Orthop Surg Rehabil. 2023 Jan 30;14:21514593231153106. doi: 10.1177/21514593231153106. eCollection 2023.
Vertebral compression fractures (VCF) are the most common low-energy fractures in older people and are associated with increased mortality. To assess mortality risk in patients suffering from VCF, we conducted a retrospective observational long-term cohort study.
The study included 270 patients. 221 patients were treated conservatively, and 49 were treated with vertebroplasty. The study group was compared to a control group of 1641 random individuals age and sex-matched. Electronic healthcare data extracted included monthly chronic medications taken regularly 3 months before hospitalisation, analgesics excluded, and date of death.
Patients who suffer from VCF tend to consume more chronic medications. The mean count of chronic medication prescriptions in the 3 months before hospitalisation was 16.41 (±9.11) in the VCF group and 11.52 (± 7.17) in the control cohort ( < .0001). In univariate analysis, patients with VCF showed decreased long-term survival ( < .00). However, when controlled for age, sex, and chronic medications uptake, no significant difference was observed between the groups in a multivariate model ( = .12).
The study demonstrates that VCF as an independent variable has a marginal effect on mortality. The higher mortality prevalent in these patients is due to the deteriorated health status of the patients before fracture.
椎体压缩性骨折(VCF)是老年人中最常见的低能量骨折,且与死亡率增加相关。为评估椎体压缩性骨折患者的死亡风险,我们开展了一项回顾性观察性长期队列研究。
该研究纳入了270例患者。其中221例患者接受保守治疗,49例接受椎体成形术治疗。将研究组与1641名年龄和性别匹配的随机个体组成的对照组进行比较。提取的电子医疗数据包括入院前3个月定期服用的每月慢性药物(不包括镇痛药)以及死亡日期。
椎体压缩性骨折患者往往服用更多的慢性药物。椎体压缩性骨折组入院前3个月慢性药物处方的平均数量为16.41(±9.11),而对照组为11.52(±7.17)(P<0.0001)。在单因素分析中,椎体压缩性骨折患者的长期生存率降低(P<0.00)。然而,在对年龄、性别和慢性药物服用情况进行控制后,多变量模型中两组之间未观察到显著差异(P=0.12)。
该研究表明,椎体压缩性骨折作为一个独立变量对死亡率的影响很小。这些患者中普遍存在的较高死亡率是由于骨折前患者健康状况恶化所致。