Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Arch Osteoporos. 2024 Aug 6;19(1):71. doi: 10.1007/s11657-024-01428-w.
This study investigated treatment trends and major adverse events in patients hospitalized for osteoporotic vertebral fracture (OVF). The frequency of surgical interventions for OVF increased significantly, but this did not decrease major adverse events. The findings underscore the necessity for reevaluating OVF management strategies.
Osteoporotic vertebral fracture (OVF) is a common condition in the aging population, often leading to increased morbidity and mortality. Here, we analyzed treatment trends and incidence of major adverse events in patients hospitalized for OVF.
We conducted a cross-sectional descriptive study, using a large Japanese hospital administrative database. The cohort included hospitalized patients aged 65 years or older, admitted for OVF from January 2015 to December 2021. The primary outcomes were the trend in the proportion of the patients undergoing surgery for OVF and the incidence of major adverse events within 30 days of admission. As a secondary outcome, we evaluated the trend in hospitalization costs.
The study cohort consisted of 14,714 patients, with a mean age of 82.4 years. There was a significant increase in surgical interventions for OVF, from 3.7% of patients in 2015 to 9.8% in 2021 (p < 0.001). The incidence of major adverse events remained unchanged, with a risk ratio of 1.09 (95% confidence interval, 0.88 to 1.35) in 2021 compared to 2015. Average hospitalization costs increased significantly, from $7,570.6 (SD 6,047.0) in 2015 to $9,502.9 (SD 7,231.5) in 2021 (p < 0.001).
Despite a significant increase in the proportion of surgical intervention for OVF, no reduction in the risk of major adverse events was observed between 2015 and 2021. Surgeons and policy makers need to interpret these findings and work towards an optimized approach to the management of OVF in the aging population.
骨质疏松性椎体骨折（OVF）是老年人群中的一种常见疾病，常导致发病率和死亡率增加。在此，我们分析了因 OVF 住院患者的治疗趋势和主要不良事件发生率。
我们进行了一项使用大型日本医院管理数据库的横断面描述性研究。队列纳入了 2015 年 1 月至 2021 年 12 月因 OVF 住院且年龄≥65 岁的患者。主要结局为 OVF 手术患者的比例趋势和入院后 30 天内主要不良事件的发生率。次要结局为评估住院费用的趋势。
研究队列包括 14714 例患者，平均年龄为 82.4 岁。OVF 的手术干预显著增加，从 2015 年的 3.7%增加到 2021 年的 9.8%（p<0.001）。主要不良事件的发生率保持不变，2021 年的风险比为 1.09（95%置信区间，0.88 至 1.35），与 2015 年相比无显著差异。平均住院费用显著增加，从 2015 年的 7570.6 美元（SD 6047.0）增加到 2021 年的 9502.9 美元（SD 7231.5）（p<0.001）。
尽管 OVF 手术干预的比例显著增加，但 2015 年至 2021 年期间主要不良事件的风险并未降低。外科医生和决策者需要解释这些发现，并努力优化老龄化人群 OVF 的管理方法。
