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Timing of symptomatic subsequent vertebral compression fracture associated with different demographic factors

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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.

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Author information

Author notes

  1. Yi-Chen Hsieh and Yi-Shan Yang are the authors contributed equally to this work.

Authors and Affiliations

  1. The PhD Program of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, 11031, Taiwan

    Yi-Chen Hsieh

  2. College of Pharmacy, PhD Program in Biotechnology Research and Development, Taipei Medical University, Taipei, 11031, Taiwan

    Yi-Chen Hsieh

  3. Master Program in Applied Molecular Epidemiology, College of Public Health, Taipei Medical University, Taipei, 11031, Taiwan

    Yi-Chen Hsieh

  4. Department of Neurosurgery, Taipei Medical University Hospital, Taipei, 11031, Taiwan

    Yi-Shan Yang, Yung-Hsiao Chiang & Jiann-Her Lin

  5. Taipei Neuroscience Institute, Taipei Medical University, Taipei, 11031, Taiwan

    Yi-Shan Yang, Yung-Hsiao Chiang & Jiann-Her Lin

  6. Graduate Institution of Data Science, College of Management, Taipei Medical University, Taipei, 11031, Taiwan

    Li-Nien Chien

  7. School of Health Care Administration, College of Management, Taipei Medical University, Taipei, 11031, Taiwan

    Li-Nien Chien

  8. Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, 11031, Taiwan

    Li-Nien Chien

  9. Division of Neurosurgery, Department of Surgery, School of Medicine, Taipei Medical University, 11031, Taipei, Taiwan

    Yung-Hsiao Chiang & Jiann-Her Lin

Authors
  1. Yi-Chen Hsieh
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  2. Yi-Shan Yang
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  4. Yung-Hsiao Chiang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Y-CH, Y-SY and L-NC. The first draft of the manuscript was written by J-HL and Y-CH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jiann-Her Lin.

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Hsieh, YC., Yang, YS., Chien, LN. et al. Timing of symptomatic subsequent vertebral compression fracture associated with different demographic factors. Eur Spine J 31, 2439–2447 (2022). https://doi.org/10.1007/s00586-022-07293-w

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  • DOI: https://doi.org/10.1007/s00586-022-07293-w

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