Survival following vertebral compression fractures in population over 65 years old

Aging Clinical and Experimental Research - Tập 35 - Trang 1609-1617 - 2023
Raquel Gutiérrez-González1,2, Ana Royuela3, Alvaro Zamarron1
1Department of Neurosurgery, Puerta de Hierro University Hospital, IDIPHISA, Majadahonda, Spain
2Department of Surgery, Faculty of Medicine. Autonomous, University of Madrid, Madrid, Spain
3Biostatistics Unit Biomedical Research Institute-IDIPHISA, Puerta de Hierro University Hospital, Majadahonda, Spain

Tóm tắt

Lower mortality has been demonstrated when vertebral compression fractures (VCFs) are treated surgically (vertebral augmentation) vs. conservatively. To analyze the overall survival in patients over 65 who suffer a VCF, to review the principal causes of death, and to detect which factors are associated with a greater risk of mortality. Patients over 65 years old diagnosed with acute, non-pathologic thoracic or lumbar VCF, treated consecutively from January 2017 to December 2020, were retrospectively selected. Those patients with follow-ups under 2 years or who required arthrodesis were excluded. Overall survival was estimated by the Kaplan–Meier method. Differences in survival were tested through the log-rank test. Multivariable Cox regression was used to assess the association of covariates and time to death. A total of 492 cases were included. Overall mortality was 36.2%. Survival rate at 1-, 12-, 24-, 48-, and 60-month follow-up was 97.4%, 86.6%, 78.0%, 64.4%, and 59.4%, respectively. Infection was the leading cause of death. The independent factors associated with a higher mortality risk were age, male, oncologic history, non-traumatic mechanism, and comorbidity during hospitalization. No statistical difference was found when comparing the two survival curves by treatment (vertebral augmentation vs. conservative) over time. Overall mortality rate was 36.2% after a median follow-up of 50.5 months (95% CI 48.2; 54.2). Age, male sex, history of oncological disease, non-traumatic mechanism of the fracture, and any comorbidity during hospitalization were identified as variables independently associated with a higher risk of mortality following a VCF in the elderly.

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Aging Clinical and Experimental Research

Tập 35

1609-1617

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