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ORTHOPEDICS AND TRAUMATOLOGY / CLINICAL RESEARCH
Associations of preoperative Oswestry Disability Index and EuroQol-5D with long-term all-cause mortality in patients undergoing percutaneous vertebroplasty
1
Department of Orthopedics, Taichung Veterans General Hospital, Taiwan
2
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan
3
Department of Computer Science and Information Engineering, Providence University, Taiwan
4
Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Taiwan
5
Department of Medical Research, Taichung Veterans General Hospital, Taiwan
6
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan
7
Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
8
Department of Food Science and Technology, Hung Kuang University, Taiwan
Submission date: 2024-09-20
Final revision date: 2025-01-21
Acceptance date: 2025-04-25
Online publication date: 2025-06-22
Corresponding author
Jun-Sing Wang
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Department of Medicine, School of Medicine, National Yang Ming Chiao, Tung University, Taiwan
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Department of Medicine, School of Medicine, National Yang Ming Chiao, Tung University, Taiwan
Arch Med Sci 2025;21(4):1381-1387
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Oswestry Disability Index (ODI) and EuroQol-5D (EQ-5D) have been widely used to assess general health quality and function in clinical studies of patients with vertebral fractures. We aimed to investigate the associations of preoperative ODI and EQ-5D with long-term mortality in patients undergoing percutaneous vertebroplasty.
Material and methods:
We retrospectively identified adult patients who had a single-level vertebral compression fracture and received percutaneous vertebroplasty between 2013 and 2020. Patients with traumatic fractures, burst fractures, and pathologic fractures, as well as those who had missing information on preoperative assessment of ODI and EQ-5D, were excluded. Survival status of the study patients was confirmed at the end of March 2021. The associations of preoperative ODI and EQ-5D with all-cause mortality were examined using Cox-proportional hazard models.
Results:
A total of 167 patients were analyzed (mean age: 75.8 ±9.3 years, 25.7% male). There were 28 patients who died during a median follow-up duration of 2.1 years (63.6 per 1000 patient-years). Preoperative ODI was significantly associated with all-cause mortality after vertebroplasty (HR = 1.049, 95% CI: 1.008 to 1.092, p = 0.018). In contrast, preoperative EQ-5D was independently associated with a lower risk of all-cause mortality after the surgery (HR = 0.202, 95% CI: 0.043 to 0.936, p = 0.041).
Conclusions:
Preoperative assessment of ODI (HR = 1.049, 95% CI: 1.008 to 1.092) and EQ-5D (HR = 0.202, 95% CI: 0.043 to 0.936) may help determine postoperative long-term mortality risk in this aging surgical population.
Oswestry Disability Index (ODI) and EuroQol-5D (EQ-5D) have been widely used to assess general health quality and function in clinical studies of patients with vertebral fractures. We aimed to investigate the associations of preoperative ODI and EQ-5D with long-term mortality in patients undergoing percutaneous vertebroplasty.
Material and methods:
We retrospectively identified adult patients who had a single-level vertebral compression fracture and received percutaneous vertebroplasty between 2013 and 2020. Patients with traumatic fractures, burst fractures, and pathologic fractures, as well as those who had missing information on preoperative assessment of ODI and EQ-5D, were excluded. Survival status of the study patients was confirmed at the end of March 2021. The associations of preoperative ODI and EQ-5D with all-cause mortality were examined using Cox-proportional hazard models.
Results:
A total of 167 patients were analyzed (mean age: 75.8 ±9.3 years, 25.7% male). There were 28 patients who died during a median follow-up duration of 2.1 years (63.6 per 1000 patient-years). Preoperative ODI was significantly associated with all-cause mortality after vertebroplasty (HR = 1.049, 95% CI: 1.008 to 1.092, p = 0.018). In contrast, preoperative EQ-5D was independently associated with a lower risk of all-cause mortality after the surgery (HR = 0.202, 95% CI: 0.043 to 0.936, p = 0.041).
Conclusions:
Preoperative assessment of ODI (HR = 1.049, 95% CI: 1.008 to 1.092) and EQ-5D (HR = 0.202, 95% CI: 0.043 to 0.936) may help determine postoperative long-term mortality risk in this aging surgical population.
REFERENCES (46)
1.
Schousboe JT. Epidemiology of vertebral fractures. J Clin Densitom 2016; 19: 8-22.
3.
Delmas PD, van de Langerijt L, Watts NB, et al.; IMPACT Study Group. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 2005; 20: 557-63.
4.
Majumdar SR, Kim N, Colman I, et al. Incidental vertebral fractures discovered with chest radiography in the emergency department: prevalence, recognition, and osteoporosis management in a cohort of elderly patients. Arch Intern Med 2005; 165: 905-9.
5.
Ballane G, Cauley JA, Luckey MM, El-Hajj Fuleihan G. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 2017; 28: 1531-42.
6.
Cosman F, Krege JH, Looker AC, et al. Spine fracture prevalence in a nationally representative sample of US women and men aged ≥40 years: results from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. Osteoporos Int 2017; 28: 1857-66.
7.
Ensrud KE, Thompson DE, Cauley JA, et al. Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture Intervention Trial Research Group. J Am Geriatr Soc 2000; 48: 241-9.
8.
Biz C, Khamisy-Farah R, Puce L, et al. Investigating and practicing orthopedics at the intersection of sex and gender: understanding the physiological basis, pathology, and treatment response of orthopedic conditions by adopting a gender lens: a narrative overview. Biomedicines 2024; 12: 974.
9.
Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults: present status and future implications. Lancet 2015; 385: 563-75.
10.
Alvarez L, Alcaraz M, Pérez-Higueras A, et al. Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures. Spine 2006; 31: 1113-8.
11.
Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361: 569-79.
12.
Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361: 557-68.
13.
Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet 2010; 376: 1085-92.
14.
McCormick JD, Werner BC, Shimer AL. Patient-reported outcome measures in spine surgery. J Am Acad Orthop Surg 2013; 21: 99-107.
16.
Tsuchiya A, Ikeda S, Ikegami N, et al. Estimating an EQ-5D population value set: the case of Japan. Health Econ 2002; 11: 341-53.
17.
Lee HM, Park SY, Lee SH, Suh SW, Hong JY. Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty. Spine J 2012; 12: 998-1005.
18.
Cheng X, Long HQ, Xu JH, Huang YL, Li FB. Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analysis. Eur Spine J 2016; 25: 3439-49.
19.
Verlaan JJ, Somers I, Dhert WJ, Oner FC. Clinical and radiological results 6 years after treatment of traumatic thoracolumbar burst fractures with pedicle screw instrumentation and balloon assisted endplate reduction. Spine J 2015; 15: 1172-8.
20.
Diel P, Reuss W, Aghayev E, Moulin P, Röder C; SWISSspine Registry Group. SWISSspine-a nationwide health technology assessment registry for balloon kyphoplasty: methodology and first results. Spine J 2010; 10: 961-71.
21.
Hübschle L, Borgström F, Olafsson G, et al.; SWISSspine Registry Group. Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry. Spine J 2014; 14: 2063-77.
22.
Si L, Winzenberg TM, de Graaff B, Palmer AJ. A systematic review and meta-analysis of utility-based quality of life for osteoporosis-related conditions. Osteoporos Int 2014; 25: 1987-97.
23.
Svedbom A, Borgstöm F, Hernlund E, et al. Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS. Osteoporos Int 2018; 29: 557-66.
24.
Akbik OS, Al-Adli N, Pernik MN, et al. A comparative analysis of frailty, disability, and sarcopenia with patient characteristics and outcomes in adult spinal deformity surgery. Global Spine J 2023; 13: 2345-56.
25.
Wuennemann F, Kintzelé L, Weber MA, Kauczor HU, Rehnitz C. Radiologische Diagnostik pathologischer Frakturen [Radiologic diagnosis of pathologic fractures]. Radiologe 2020; 60: 498-505.
26.
Biz C, Buffon L, Scapinello D, et al. Nursing leadership in a post-pandemic elective orthopaedic theatre department: a detailed thematic analysis of an open-ended qualitative survey. Nurs Rep 2024; 14: 1541-52.
27.
Solberg TK, Olsen JA, Ingebrigtsen T, Hofoss D, Nygaard OP. Health-related quality of life assessment by the EuroQol-5D can provide cost-utility data in the field of low-back surgery. Eur Spine J 2005; 14: 1000-7.
28.
Stokes OM, Cole AA, Breakwell LM, Lloyd AJ, Leonard CM, Grevitt M. Do we have the right PROMs for measuring outcomes in lumbar spinal surgery? Eur Spine J 2017; 26: 816-24.
29.
Godil SS, Parker SL, Zuckerman SL, Mendenhall SK, Glassman SD, McGirt MJ. Accurately measuring the quality and effectiveness of lumbar surgery in registry efforts: determining the most valid and responsive instruments. Spine J 2014; 14: 2885-91.
30.
Austin PC. Graphical methods to illustrate the nature of the relation between a continuous variable and the outcome when using restricted cubic splines with a Cox proportional hazards model. Stat Methods Med Res 2025; 34: 277-85.
31.
Di Bari M, Chiarlone M, Matteuzzi D, et al. Thoracic kyphosis and ventilatory dysfunction in unselected older persons: an epidemiological study in Dicomano, Italy. J Am Geriatr Soc 2004; 52: 909-15.
32.
Katzman WB, Huang MH, Lane NE, Ensrud KE, Kado DM. Kyphosis and decline in physical function over 15 years in older community-dwelling women: the Study of Osteoporotic Fractures. J Gerontol A Biol Sci Med Sci 2013; 68: 976-83.
33.
Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med 2007; 147: 330-8.
34.
Kendler DL, Bauer DC, Davison KS, et al. Vertebral fractures: clinical importance and management. Am J Med 2016; 129: 221.e1-10.
35.
Morin S, Lix LM, Azimaee M, Metge C, Caetano P, Leslie WD. Mortality rates after incident non-traumatic fractures in older men and women. Osteoporos Int 2011; 22: 2439-48.
36.
McCullough BJ, Comstock BA, Deyo RA, Kreuter W, Jarvik JG. Major medical outcomes with spinal augmentation vs conservative therapy. JAMA Intern Med 2013; 173: 1514-21.
37.
Clark W, Lyon S, Burnes J. Trials of vertebroplasty for vertebral fractures. N Engl J Med 2009; 361: 2097-8; author reply 2099-100.
38.
Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009; 301: 513-21.
39.
Son KY, Shin DW, Lee JE, Kim SH, Yun JM, Cho B. Association of timed up and go test outcomes with future incidence of cardiovascular disease and mortality in adults aged 66 years: Korean national representative longitudinal study over 5.7 years. BMC Geriatr 2020; 20: 111.
40.
Cheong CY, Yap P, Gwee X, et al. Physical and functional measures predicting long-term mortality in community-dwelling older adults: a comparative evaluation in the Singapore Longitudinal Ageing Study. Aging 2021; 13: 25038-54.
41.
Ascencio EJ, Cieza-Gómez GD, Carrillo-Larco RM, Ortiz PJ. Timed up and go test predicts mortality in older adults in Peru: a population-based cohort study. BMC Geriatr 2022; 22: 61.
42.
Phyo AZZ, Ryan J, Gonzalez-Chica DA, et al.; ASPREE Investigator Group. Health-related quality of life and all-cause mortality among older healthy individuals in Australia and the United States: a prospective cohort study. Qual Life Res 2021; 30: 1037-48.
43.
Gobbens RJJ, van der Ploeg T. The prediction of mortality by quality of life assessed with the WHOQOL-BREF: a longitudinal analysis at the domain and item levels using a seven-year follow-up period. Qual Life Res 2021; 30: 1951-62.
44.
Edidin AA, Ong KL, Lau E, Kurtz SM. Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res 2011; 26: 1617-26.
45.
McDonald RJ, Achenbach SJ, Atkinson EJ, et al. Mortality in the vertebroplasty population. AJNR Am J Neuroradiol 2011; 32: 1818-23.
46.
Clement ND, Patton RFL, MacDonald DJ, Duckworth AD. Preoperative health-related quality of life is independently associated with postoperative mortality risk following total hip or knee arthroplasty: seven to eight years’ follow-up. Bone Jt Open 2022; 3: 933-40.
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