Yi-Chen Hsieh1,2,3, Yi-Shan Yang4,5, Li-Nien Chien6,7,8, Yung-Hsiao Chiang4,5,9, Jiann-Her Lin10,11,12. 1. The PhD Program of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, 11031, Taiwan. 2. College of Pharmacy, PhD Program in Biotechnology Research and Development, Taipei Medical University, Taipei, 11031, Taiwan. 3. Master Program in Applied Molecular Epidemiology, College of Public Health, Taipei Medical University, Taipei, 11031, Taiwan. 4. Department of Neurosurgery, Taipei Medical University Hospital, Taipei, 11031, Taiwan. 5. Taipei Neuroscience Institute, Taipei Medical University, Taipei, 11031, Taiwan. 6. Graduate Institution of Data Science, College of Management, Taipei Medical University, Taipei, 11031, Taiwan. 7. School of Health Care Administration, College of Management, Taipei Medical University, Taipei, 11031, Taiwan. 8. Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, 11031, Taiwan. 9. Division of Neurosurgery, Department of Surgery, School of Medicine, Taipei Medical University, 11031, Taipei, Taiwan. 10. Department of Neurosurgery, Taipei Medical University Hospital, Taipei, 11031, Taiwan. jiannher@me.com. 11. Taipei Neuroscience Institute, Taipei Medical University, Taipei, 11031, Taiwan. jiannher@me.com. 12. Division of Neurosurgery, Department of Surgery, School of Medicine, Taipei Medical University, 11031, Taipei, Taiwan. jiannher@me.com.
Abstract
BACKGROUND: Symptomatic subsequent vertebral compression fracture (VCF; SVCF) is a common complication associated with poor outcomes. Accumulating evidence shows that demographic factors and incidences of symptomatic SVCFs differ during different periods after the primary vertebroplasty (VP). PURPOSE: To investigate the incidence and demographic factors of symptomatic SVCFs after the primary VP in different periods using registry data in the Taiwan National Health Insurance Research Database. METHODS: This retrospective cohort study included 28,343 patients aged ≥ 50 years with painful VCF treated with VP from 2002 to 2016. Symptomatic SVCF was defined as SVCF requiring another VP or re-admission. During the 2-year follow-up, 1955 patients received subsequent VP while 1,407 were readmitted. Cox proportional hazard models were used to compare the risks of subsequent VP or readmission. RESULTS: The cumulative incident rate of subsequent VP and re-hospitalization was 0.87 [95% confidence interval (CI), 0.82 ~ 0.92] and 0.62 (95% CI, 0.58 ~ 0.66) per 100 person-months, respectively, within the first 6 months after the primary VP, and it decreased over time. A multiple Cox regression model showed that age, osteopenia or osteoporosis, Charlson comorbidity index (CCI) were significant independent risk factors of subsequent VP or readmission within the first 6 months. CONCLUSIONS: This study demonstrated that the incidence of symptomatic SVCF peaked in the first 6 months after the primary VP. Age, osteoporosis or osteopenia, and CCI were determined to be risk factors in the first 6 months, but only osteoporosis or osteopenia and CCI were risk factors thereafter.
BACKGROUND: Symptomatic subsequent vertebral compression fracture (VCF; SVCF) is a common complication associated with poor outcomes. Accumulating evidence shows that demographic factors and incidences of symptomatic SVCFs differ during different periods after the primary vertebroplasty (VP). PURPOSE: To investigate the incidence and demographic factors of symptomatic SVCFs after the primary VP in different periods using registry data in the Taiwan National Health Insurance Research Database. METHODS: This retrospective cohort study included 28,343 patients aged ≥ 50 years with painful VCF treated with VP from 2002 to 2016. Symptomatic SVCF was defined as SVCF requiring another VP or re-admission. During the 2-year follow-up, 1955 patients received subsequent VP while 1,407 were readmitted. Cox proportional hazard models were used to compare the risks of subsequent VP or readmission. RESULTS: The cumulative incident rate of subsequent VP and re-hospitalization was 0.87 [95% confidence interval (CI), 0.82 ~ 0.92] and 0.62 (95% CI, 0.58 ~ 0.66) per 100 person-months, respectively, within the first 6 months after the primary VP, and it decreased over time. A multiple Cox regression model showed that age, osteopenia or osteoporosis, Charlson comorbidity index (CCI) were significant independent risk factors of subsequent VP or readmission within the first 6 months. CONCLUSIONS: This study demonstrated that the incidence of symptomatic SVCF peaked in the first 6 months after the primary VP. Age, osteoporosis or osteopenia, and CCI were determined to be risk factors in the first 6 months, but only osteoporosis or osteopenia and CCI were risk factors thereafter.
Authors: Robert L Tatsumi; Alexander C Ching; Gregory D Byrd; Jayme R Hiratzka; Judson E Threlkeld; Robert A Hart Journal: Spine J Date: 2010-11 Impact factor: 4.166