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

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...

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Main Authors: Ong, Terence, Kantachuvesiri, Pitchayud, Sahota, Opinder, Gladman, John R.F.
Format: Article
Published: Oxford University Press 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/44712/
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author Ong, Terence
Kantachuvesiri, Pitchayud
Sahota, Opinder
Gladman, John R.F.
author_facet Ong, Terence
Kantachuvesiri, Pitchayud
Sahota, Opinder
Gladman, John R.F.
author_sort Ong, Terence
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-447122020-05-04T19:24:38Z https://eprints.nottingham.ac.uk/44712/ Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review Ong, Terence Kantachuvesiri, Pitchayud Sahota, Opinder Gladman, John R.F. 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. Oxford University Press 2018-01-01 Article PeerReviewed Ong, Terence, Kantachuvesiri, Pitchayud, Sahota, Opinder and Gladman, John R.F. (2018) Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review. Age and Ageing, 47 (1). pp. 17-25. ISSN 1468-2834 vertebral fragility fracture hospital osteoporosis older people https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afx079 doi:10.1093/ageing/afx079 doi:10.1093/ageing/afx079
spellingShingle vertebral fragility fracture
hospital
osteoporosis
older people
Ong, Terence
Kantachuvesiri, Pitchayud
Sahota, Opinder
Gladman, John R.F.
Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title_full Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title_fullStr Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title_full_unstemmed Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title_short Characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
title_sort characteristics and outcomes of hospitalised patients with vertebral fragility fractures: a systematic review
topic vertebral fragility fracture
hospital
osteoporosis
older people
url https://eprints.nottingham.ac.uk/44712/
https://eprints.nottingham.ac.uk/44712/
https://eprints.nottingham.ac.uk/44712/