Life Expectancy Following Diagnosis of a Vertebral Compression Fracture

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2012 Mar 17

PMID 22422305

Citations 18

Authors

A A Edidin

K L Ong

E Lau

S M Kurtz

Affiliations

Soon will be listed here.

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.

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References

Klazen C, Lohle P, de Vries J, Jansen F, Tielbeek A, Blonk M . Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 2010; 376(9746):1085-92. DOI: 10.1016/S0140-6736(10)60954-3. View

Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W . Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004; 350(23):2335-42. DOI: 10.1056/NEJMoa032691. View

Deyo R, Cherkin D, Ciol M . Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-9. DOI: 10.1016/0895-4356(92)90133-8. View

Cooper C . Osteoporosis: disease severity and consequent fracture management. Osteoporos Int. 2010; 21 Suppl 2:S425-9. DOI: 10.1007/s00198-010-1251-0. View

Gill J, Kuper M, Chin P, Zhang Y, Schutt Jr R . Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician. 2007; 10(4):583-90. View

Strom O, Leonard C, Marsh D, Cooper C . Cost-effectiveness of balloon kyphoplasty in patients with symptomatic vertebral compression fractures in a UK setting. Osteoporos Int. 2009; 21(9):1599-608. DOI: 10.1007/s00198-009-1096-6. View

Zampini J, White A, McGuire K . Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty. Clin Orthop Relat Res. 2010; 468(7):1773-80. PMC: 2882011. DOI: 10.1007/s11999-010-1279-7. View

Kado D, Browner W, Palermo L, Nevitt M, Genant H, Cummings S . Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1999; 159(11):1215-20. DOI: 10.1001/archinte.159.11.1215. View

Buchbinder R, Osborne R, Ebeling P, Wark J, Mitchell P, Wriedt C . A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009; 361(6):557-68. DOI: 10.1056/NEJMoa0900429. View

10.

Gaitatzis A, Johnson A, Chadwick D, Shorvon S, Sander J . Life expectancy in people with newly diagnosed epilepsy. Brain. 2004; 127(Pt 11):2427-32. DOI: 10.1093/brain/awh267. View

11.

Cooper C, Atkinson E, Jacobsen S, OFallon W, Melton 3rd L . Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993; 137(9):1001-5. DOI: 10.1093/oxfordjournals.aje.a116756. View

12.

Mitka M . US government kicks off program for comparative effectiveness research. JAMA. 2010; 304(20):2230-1. DOI: 10.1001/jama.2010.1663. View

13.

Puvimanasinghe J, Takkenberg J, Eijkemans M, Steyerberg E, van Herwerden L, Grunkemeier G . Prognosis after aortic valve replacement with the Carpentier-Edwards pericardial valve: use of microsimulation. Ann Thorac Surg. 2005; 80(3):825-31. DOI: 10.1016/j.athoracsur.2005.03.064. View

14.

Thorpe J . Comparative effectiveness research and health reform: implications for public health policy and practice. Public Health Rep. 2010; 125(6):909-12. PMC: 2966676. DOI: 10.1177/003335491012500619. View

15.

Al-Khatib S, Anstrom K, Eisenstein E, Peterson E, Jollis J, Mark D . Clinical and economic implications of the Multicenter Automatic Defibrillator Implantation Trial-II. Ann Intern Med. 2005; 142(8):593-600. DOI: 10.7326/0003-4819-142-8-200504190-00007. View

16.

Wardlaw D, Cummings S, Van Meirhaeghe J, Bastian L, Tillman J, Ranstam J . Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009; 373(9668):1016-24. DOI: 10.1016/S0140-6736(09)60010-6. View

17.

Kallmes D, Comstock B, Heagerty P, Turner J, Wilson D, Diamond T . A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009; 361(6):569-79. PMC: 2930487. DOI: 10.1056/NEJMoa0900563. View

18.

Edidin A, Ong K, Lau E, Kurtz S . Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res. 2011; 26(7):1617-26. DOI: 10.1002/jbmr.353. View