Abstract
Summary
We described the whole population of patients hospitalized for vertebral fractures in France in 2009. Only 6.4 % of them were operated by vertebroplasty; these patients were younger and healthier than non-operated patients.
Introduction
This study aims to describe the burden of vertebral fractures from the 2009 French Hospital National Database in acute care in people aged 60 years and over, with or without vertebroplasty.
Methods
All stays due to nonmalignant and nontraumatic vertebral fractures as primary cause were selected. Patients’ characteristics were described and compared between patients with or without vertebroplasty. The in-patient mortality was compared to the one related to hip and upper humerus fracture in patients hospitalized during the same year.
Results
In 2009, 13,624 patients were hospitalized for vertebral fracture. Men accounted for 29.3 % of cases. Length of stay was 9.6 ± 8.2 days, higher in patients with at least one comorbidity than in patients without (11.2 ± 8.6 and 7.8 ± 7.2 days, respectively). The in-patient mortality was 0.9 %; it was 3.8 and 1.1 % for hip and upper humerus fractures, respectively. Vertebroplasty was performed in 6.4 % of them. Patients with vertebroplasty were younger (mean age of 75 ± 8 versus 79 ± 9 years), had a less duration of stay (7 ± 7.5 versus 9.8 ± 8.2 days), less comorbidities (at least one comorbidity, 45 versus 54 %), and less in-patient mortality (0.1 versus 0.9 %). Rehospitalization for vertebral fracture occurred in 9 and 6 % of the patient with and without vertebroplasty.
Conclusion
This is the first French study assessing the national burden of vertebral fractures based on hospital data. In-hospital death rate is lower in patients with vertebroplasty, who are younger and have less comorbidities than the general population with vertebral fractures.
Similar content being viewed by others
References
O’Neill TW, Cockerill W, Matthis C et al (2004) Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int 15:760–765
Fechtenbaum J, Cropet C, Kolta S, Horlait S, Orcel P, Roux C (2005) The severity of vertebral fractures and health-related quality of life in osteoporotic postmenopausal women. Osteoporos Int 16:2175–2179
Center JR, Bliuc D, Nguyen TV et al (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394
Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–882
Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: The Study of Osteoporotic Fracture. Arch Intern Med 159:1215–1220
Ensrud KE, Thompson DE, Cauley JA et al (2000) Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. J Am Geriatr Soc 48:241–249
Ismail AA, O’Neill TW, Cooper C et al (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8:291–297
Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561
Bliuc D, Nguyen ND, Milch VE et al (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521
Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fracture. Osteoporos Int 15:108–112
Roux C, Fechtenbaum J, Kolta S, Said-Nahal R, Briot K, Benhamou CL (2010) Prospective assessment of thoracic kyphosis in postmenopausal women with osteoporosis. J Bone Miner Res 25:362–368
Bouza C, Lopez T, Palma M, Amate JM (2007) Hospitalized osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 18:649–657
Kallmes DF, Comstock BA, Heagerty PJ et al (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361:569–579
Buchbinder R, Osborne RH, Ebeling PR et al (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361:557–568
Edidin AA, Ong KL, Lau E, Kurtz SM (2011) Mortality risk for operated and non-operated vertebral fracture patients in the Medicare population. J Bone Miner Res. doi:10.1002/jbmr.353
Zampino JM, White AP, McGuire KJ (2010) Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty. Clin Orthop Relat Res 468:1773–1780
Maravic M, Le Bihan C, Richard JB et al (2005) Incidence and cost of osteoporotic fractures in France during. A methodological approach by the national hospital database. Osteoporos Int 16(12):1475–1480
Maravic M, Taupin P, Landais P, Roux C (2011) Change in hip fracture incidence over the last six years in France. Osteoporos Int 22:797–801
Papaioannou A, Adachi JD, Parkinson W, Stephenson G, Bedard M (2001) Lengthy hospitalization associated with vertebral fractures despite control for comorbid conditions. Osteoporos Int 12:870–874
Phillips S, Fox N, Jacobs J, Wright WE (1986) The direct medical costs of osteoporosis for American women aged 45 and older. Bone 9:271–279
Johnell O, Gullberg B, Kanis JA (1997) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7:138–144
McDonald RJ, Achenbach SJ, Atkinson EJ, Gray LA, Cloft HJ, Melton LJ III, Kallmes DF (2011) Mortality in the vertebroplasty population. Am J N Rad 32:1818–1823
Lee YK, Jang S, Jang S, Lee HJ, Park C, Ha YC, Kim DY (2012) Mortality after vertebral fracture in Korea. Analysis of the National Claim Registry. Osteoporos Int 23:1859–1865
Gehlbach SH, Bigelow C, Heimisdoltir M et al (2000) Recognition of vertebral fractures in a clinical setting. Osteoporos Int 11:577–582
Acknowledgments
This work is supported by the Collège Français des Médecins Rhumatologues (CFMR).
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Maravic, M., Taupin, P. & Roux, C. Hospital burden of vertebral fractures in France: influence of vertebroplasty. Osteoporos Int 24, 2001–2006 (2013). https://doi.org/10.1007/s00198-012-2264-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-012-2264-7