Abstract

Background Context: Whether early vertebroplasty (VP) (within 3 months) offers extra benefit to aged patients older than 70 years with painful vertebral compression fractures (PVCF) in terms of mortality and respiratory-related morbidity remains unknown, given that the elderly is associated with higher surgical risks. Purpose: To elucidate the benefits of an early VP intervention for aged patients with a PVCF by comparing the risks of mortality and respiratory-related morbidity. Study Design: A retrospective propensity score matched cohort. Patient Sample: PVCF patients with an early VP and without an early VP intervention. Outcome Measures: Death, pneumonia, and respiratory failure. Methods: A total of 10,785 PVCF patients who used analgesic injection during admission from 2000 through 2013 were selected from the National Health Insurance Research Database in Taiwan. After matching, there were 1773 VP patients and 5324 non-VP patients included in this study. Conditional Cox proportional hazard models were used to determine the risk of death and respiratory complications. Results: The incidences of death at 1 year of VP and non-VP patients were 0.46 (95% confidence interval [CI]: 0.38-0.56) and 0.63 (95% CI: 0.57-0.70) per 100 person-months, respectively. We observed a hazard ratio (HR) of 1.39 (95% CI: 1.09-1.78, p=.008) when comparing non-VP to VP patients. This phenomenon was seen when estimating the benefits of respiratory failure (HR: 1.46; 95% CI: 1.04-2.05, p=.028). Conclusion: The results showed that VP was associated with lower risks of mortality and respiratory failure in aged patients with a PVCF. VP should be considered a priority for the aged patients with a PVCF requiring admission and analgesics.

Original languageEnglish
JournalSpine Journal
DOIs
Publication statusPublished - 2017

Fingerprint

Vertebroplasty
Compression Fractures
Taiwan
Respiratory Insufficiency
Cohort Studies
Mortality
Population
Confidence Intervals
Analgesics
Morbidity
Propensity Score
National Health Programs
Proportional Hazards Models
Pneumonia

Keywords

  • Mortality
  • National Health Insurance Research Database
  • Painful vertebral compression fracture
  • Respiratory failure
  • The elderly
  • Vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{378dab131a07462b8661f63b93955adb,
title = "Early vertebroplasty associated with a lower risk of mortality and respiratory failure in aged patients with painful vertebral compression fractures: A population-based cohort study in Taiwan",
abstract = "Background Context: Whether early vertebroplasty (VP) (within 3 months) offers extra benefit to aged patients older than 70 years with painful vertebral compression fractures (PVCF) in terms of mortality and respiratory-related morbidity remains unknown, given that the elderly is associated with higher surgical risks. Purpose: To elucidate the benefits of an early VP intervention for aged patients with a PVCF by comparing the risks of mortality and respiratory-related morbidity. Study Design: A retrospective propensity score matched cohort. Patient Sample: PVCF patients with an early VP and without an early VP intervention. Outcome Measures: Death, pneumonia, and respiratory failure. Methods: A total of 10,785 PVCF patients who used analgesic injection during admission from 2000 through 2013 were selected from the National Health Insurance Research Database in Taiwan. After matching, there were 1773 VP patients and 5324 non-VP patients included in this study. Conditional Cox proportional hazard models were used to determine the risk of death and respiratory complications. Results: The incidences of death at 1 year of VP and non-VP patients were 0.46 (95{\%} confidence interval [CI]: 0.38-0.56) and 0.63 (95{\%} CI: 0.57-0.70) per 100 person-months, respectively. We observed a hazard ratio (HR) of 1.39 (95{\%} CI: 1.09-1.78, p=.008) when comparing non-VP to VP patients. This phenomenon was seen when estimating the benefits of respiratory failure (HR: 1.46; 95{\%} CI: 1.04-2.05, p=.028). Conclusion: The results showed that VP was associated with lower risks of mortality and respiratory failure in aged patients with a PVCF. VP should be considered a priority for the aged patients with a PVCF requiring admission and analgesics.",
keywords = "Mortality, National Health Insurance Research Database, Painful vertebral compression fracture, Respiratory failure, The elderly, Vertebroplasty",
author = "Lin, {Jiann Her} and Chien, {Li Nien} and Tsai, {Wan Ling} and Chen, {Li Ying} and Chiang, {Yung Hsiao} and Hsieh, {Yi Chen}",
year = "2017",
doi = "10.1016/j.spinee.2017.05.001",
language = "English",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Early vertebroplasty associated with a lower risk of mortality and respiratory failure in aged patients with painful vertebral compression fractures

T2 - A population-based cohort study in Taiwan

AU - Lin, Jiann Her

AU - Chien, Li Nien

AU - Tsai, Wan Ling

AU - Chen, Li Ying

AU - Chiang, Yung Hsiao

AU - Hsieh, Yi Chen

PY - 2017

Y1 - 2017

N2 - Background Context: Whether early vertebroplasty (VP) (within 3 months) offers extra benefit to aged patients older than 70 years with painful vertebral compression fractures (PVCF) in terms of mortality and respiratory-related morbidity remains unknown, given that the elderly is associated with higher surgical risks. Purpose: To elucidate the benefits of an early VP intervention for aged patients with a PVCF by comparing the risks of mortality and respiratory-related morbidity. Study Design: A retrospective propensity score matched cohort. Patient Sample: PVCF patients with an early VP and without an early VP intervention. Outcome Measures: Death, pneumonia, and respiratory failure. Methods: A total of 10,785 PVCF patients who used analgesic injection during admission from 2000 through 2013 were selected from the National Health Insurance Research Database in Taiwan. After matching, there were 1773 VP patients and 5324 non-VP patients included in this study. Conditional Cox proportional hazard models were used to determine the risk of death and respiratory complications. Results: The incidences of death at 1 year of VP and non-VP patients were 0.46 (95% confidence interval [CI]: 0.38-0.56) and 0.63 (95% CI: 0.57-0.70) per 100 person-months, respectively. We observed a hazard ratio (HR) of 1.39 (95% CI: 1.09-1.78, p=.008) when comparing non-VP to VP patients. This phenomenon was seen when estimating the benefits of respiratory failure (HR: 1.46; 95% CI: 1.04-2.05, p=.028). Conclusion: The results showed that VP was associated with lower risks of mortality and respiratory failure in aged patients with a PVCF. VP should be considered a priority for the aged patients with a PVCF requiring admission and analgesics.

AB - Background Context: Whether early vertebroplasty (VP) (within 3 months) offers extra benefit to aged patients older than 70 years with painful vertebral compression fractures (PVCF) in terms of mortality and respiratory-related morbidity remains unknown, given that the elderly is associated with higher surgical risks. Purpose: To elucidate the benefits of an early VP intervention for aged patients with a PVCF by comparing the risks of mortality and respiratory-related morbidity. Study Design: A retrospective propensity score matched cohort. Patient Sample: PVCF patients with an early VP and without an early VP intervention. Outcome Measures: Death, pneumonia, and respiratory failure. Methods: A total of 10,785 PVCF patients who used analgesic injection during admission from 2000 through 2013 were selected from the National Health Insurance Research Database in Taiwan. After matching, there were 1773 VP patients and 5324 non-VP patients included in this study. Conditional Cox proportional hazard models were used to determine the risk of death and respiratory complications. Results: The incidences of death at 1 year of VP and non-VP patients were 0.46 (95% confidence interval [CI]: 0.38-0.56) and 0.63 (95% CI: 0.57-0.70) per 100 person-months, respectively. We observed a hazard ratio (HR) of 1.39 (95% CI: 1.09-1.78, p=.008) when comparing non-VP to VP patients. This phenomenon was seen when estimating the benefits of respiratory failure (HR: 1.46; 95% CI: 1.04-2.05, p=.028). Conclusion: The results showed that VP was associated with lower risks of mortality and respiratory failure in aged patients with a PVCF. VP should be considered a priority for the aged patients with a PVCF requiring admission and analgesics.

KW - Mortality

KW - National Health Insurance Research Database

KW - Painful vertebral compression fracture

KW - Respiratory failure

KW - The elderly

KW - Vertebroplasty

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U2 - 10.1016/j.spinee.2017.05.001

DO - 10.1016/j.spinee.2017.05.001

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JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

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