| Title |
Were VCF patients at higher risk of mortality following the 2009 publication of the vertebroplasty “sham” trials?
|
|---|---|
| Published in |
Osteoporosis International, October 2017
|
| DOI | 10.1007/s00198-017-4281-z |
| Pubmed ID | |
| Authors |
K. L. Ong, D. P. Beall, M. Frohbergh, E. Lau, J. A. Hirsch |
| Abstract |
The 5-year period following 2009 saw a steep reduction in vertebral augmentation volume and was associated with elevated mortality risk in vertebral compression fracture (VCF) patients. The risk of mortality following a VCF diagnosis was 85.1% at 10 years and was found to be lower for balloon kyphoplasty (BKP) and vertebroplasty (VP) patients. BKP and VP are associated with lower mortality risks than non-surgical management (NSM) of VCF. VP versus sham trials published in 2009 sparked controversy over its effectiveness, leading to diminished referral volumes. We hypothesized that lower BKP/VP utilization would lead to a greater mortality risk for VCF patients. BKP/VP utilization was evaluated for VCF patients in the 100% US Medicare data set (2005-2014). Survival and morbidity were analyzed by the Kaplan-Meier method and compared between NSM, BKP, and VP using Cox regression with adjustment by propensity score and various factors. The cohort included 261,756 BKP (12.6%) and 117,232 VP (5.6%) patients, comprising 20% of the VCF patient population in 2005, peaking at 24% in 2007-2008, and declining to 14% in 2014. The propensity-adjusted mortality risk for VCF patients was 4% (95% CI, 3-4%; p < 0.001) greater in 2010-2014 versus 2005-2009. The 10-year risk of mortality for the overall cohort was 85.1%. BKP and VP cohorts had a 19% (95% CI, 19-19%; p < 0.001) and 7% (95% CI, 7-8%; p < 0.001) lower propensity-adjusted 10-year mortality risk than the NSM cohort, respectively. The BKP cohort had a 13% (95% CI, 12-13%; p < 0.001) lower propensity-adjusted 10-year mortality risk than the VP cohort. Changes in treatment patterns following the 2009 VP publications led to fewer augmentation procedures. In turn, the 5-year period following 2009 was associated with elevated mortality risk in VCF patients. This provides insight into the implications of treatment pattern changes and associated mortality risks. |
X Demographics
The data shown below were collected from the profiles of 45 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 30 | 67% |
| Jordan | 1 | 2% |
| Mexico | 1 | 2% |
| Australia | 1 | 2% |
| Netherlands | 1 | 2% |
| United Kingdom | 1 | 2% |
| Unknown | 10 | 22% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 21 | 47% |
| Practitioners (doctors, other healthcare professionals) | 19 | 42% |
| Scientists | 5 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 13% |
| Other | 5 | 11% |
| Researcher | 4 | 9% |
| Student > Master | 4 | 9% |
| Student > Doctoral Student | 3 | 6% |
| Other | 9 | 19% |
| Unknown | 16 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 34% |
| Linguistics | 3 | 6% |
| Nursing and Health Professions | 3 | 6% |
| Neuroscience | 2 | 4% |
| Psychology | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 21 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 265. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2022.
All research outputs
#137,675
of 25,494,370 outputs
Outputs from Osteoporosis International
#13
of 3,862 outputs
Outputs of similar age
#2,893
of 338,552 outputs
Outputs of similar age from Osteoporosis International
#2
of 66 outputs
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