Life expectancy after vertebral fracture varies by treatment
MedWire News: Life expectancy following a vertebral compression fracture is better when treated with balloon kyphoplasty than with vertebroplasty, an analysis of US Medicare data suggests.
The findings provide valuable cost-effectiveness information and may help guide decision-making in these patients, say the researchers writing in Osteoporosis International.
Kevin Ong (Exponent, Inc, Philadelphia, Pennsylvania, USA) and team used data from the national Medicare database to evaluate life expectancy following vertebral compression fracture as a function of treatment.
Between 2005 and 2008, 858,978 patients were diagnosed with vertebral compression fracture. Of these, 119,253 (13.9%) were treated with kyphoplasty, 63,693 (7.4%) were treated with vertebroplasty, and the remainder were managed conservatively.
Life expectancy was measured for each patient from the time of diagnosis to either death or the end of the study period (December 31, 2008), and stratified by age and gender.
Median life expectancy in the overall cohort was a significant 85% longer in patients who were managed surgically than in those managed conservatively, report the authors.
The magnitude of difference between these groups ranged from 2.2 years to 7.3 years depending on the particular subgroup. For instance, the median life expectancy for women aged 65-69 years was 12.7 years for non-operated patients but 20.1 years for operated patients; in men aged 65-69 years, the corresponding figures were 7.6 years and 12.7 years, respectively.
After adjusting for confounders, life expectancy was 115% greater and 44% greater in patients treated with kyphoplasty and vertebroplasty, respectively, compared with non-operated patients.
Furthermore, kyphoplasty patients had a 34% greater adjusted life expectancy than vertebroplasty patients.
"While preliminary, the cost-effectiveness of surgical management of vertebral compression fracture Medicare beneficiaries using kyphoplasty compares favorably with the criteria for accepted life-extending technologies," remark Ong and co-authors.
They conclude: "The results of the present study, which characterizes the life expectancy for vertebral compression fracture treated hospital patients and outpatients, will be a useful basis for future cost-effectiveness studies for the Medicare population."
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By Joanna Lyford