Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population

Vertebral compression fractures (VCFs) are associated with increased mortality risk, but the association between surgical treatment and survivorship is unclear. We evaluated the mortality risk for VCF patients undergoing conservative treatment (nonoperated), kyphoplasty, and vertebroplasty. Survival...

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Bibliographic Details
Published in:Journal of bone and mineral research 2011-07, Vol.26 (7), p.1617-1626
Main Authors: Edidin, Avram Allan, Ong, Kevin L, Lau, Edmund, Kurtz, Steven M
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cohort Studies
Female
Fractures, Compression - diagnosis
Fractures, Compression - mortality
Fractures, Compression - surgery
Humans
Kyphoplasty
Male
Medicare
Medicare - statistics & numerical data
Mortality
Risk Factors
Spinal Fractures - diagnosis
Spinal Fractures - mortality
Spinal Fractures - surgery
United States - epidemiology
Vertebral Compression Fracture
Vertebroplasty
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Summary:Vertebral compression fractures (VCFs) are associated with increased mortality risk, but the association between surgical treatment and survivorship is unclear. We evaluated the mortality risk for VCF patients undergoing conservative treatment (nonoperated), kyphoplasty, and vertebroplasty. Survival of VCF patients in the 100% U.S. Medicare data set (2005–2008) was estimated by the Kaplan‐Meier method, and the differences in mortality rates at up to 4 years were assessed by Cox regression (adjusted for comorbidities) between operated and nonoperated patients and between kyphoplasty and vertebroplasty patients. An instrumental variables analysis was used to evaluate mortality‐rate difference between kyphoplasty and vertebroplasty patients. A total of 858,978 VCF patients were identified, including 119,253 kyphoplasty patients and 63,693 vertebroplasty patients. At up to 4 years of follow‐up, patients in the operated cohort had a higher adjusted survival rate of 60.8% compared with 50.0% for patients in the nonoperated cohort (p 
ISSN:0884-0431
1523-4681
DOI:10.1002/jbmr.353