Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review

Ong, Terence; Kantachuvesiri, Pitchayud; Sahota, Opinder; Gladman, John R.F.

Abstract

Background: The complex management for patients presenting to hospital with vertebral fragility fractures provides justification for the development of specific services for them. A systematic review was undertaken to determine the incidence of hospital admission, patient characteristics, and health outcomes of vertebral fragility fracture patients to inform the development of such a service.

Methods: Non-randomised studies of vertebral fragility fracture in hospital were included. Searches were conducted using electronic databases and citation searching of the included papers.

Results: 19 studies were included. The incidence of hospital admission varied from 2.8-19.3 per 10,000/year. The average patient age was 81 years, the majority having presented with a fall. A diagnosis of osteoporosis or previous fragility fracture was reported in around one third of patients. Most patients (75% men and 78% women) had five or more co-pathologies. Most patients were managed non-operatively with a median hospital length of stay of 10 days. One third of patients were started on osteoporosis treatment. Inpatient and one year mortality was between 0.9-3.5%, and 20–25% respectively: between 34-50% were discharged from hospital to a care facility. Many patients were more dependent with activities of daily living on discharge compared to their pre-admission level. Older age and increasing comorbidities was associated with longer hospital stay and higher mortality.

Conclusion: These findings indicate that specific hospital services for patients with vertebral fragility fractures should take into consideration local hospitalisation rates for the condition, and should be multifaceted - providing access to diagnostic, therapeutic, surgical and rehabilitation interventions.

Citation

Ong, T., Kantachuvesiri, P., Sahota, O., & Gladman, J. R. (2018). Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review. Age and Ageing, 47(1), 17-25. https://doi.org/10.1093/ageing/afx079

• Journal Article Type: Article
• Acceptance Date: Mar 31, 2017
• Online Publication Date: May 10, 2017
• Publication Date: Jan 1, 2018
• Deposit Date: Aug 7, 2017
• Publicly Available Date: Aug 7, 2017
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 47
• Issue: 1
• Pages: 17-25
• DOI: https://doi.org/10.1093/ageing/afx079
• Keywords: vertebral fragility fracture, hospital, osteoporosis, older people
• Public URL: https://nottingham-repository.worktribe.com/output/902278
• Publisher URL: https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afx079
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record Terence Ong, Pitchayud Kantachuvesiri, Opinder Sahota, John R. F. Gladman; Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review, Age and Ageing is available online at: https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afx079#.
• Contract Date: Aug 7, 2017