Abstract

Introduction

Vertebral fragility fractures (VFF) are the most common osteoporotic fracture. VFF can result in significant pain requiring hospitalisation. However, there is little data on patient numbers, hospital bed days and costs, contributed to by these patients.

Methodology

We report a retrospective analysis of patients aged 55 years and over admitted to hospitals across England from 2017-2019. ICD-10 classifications for VFF and OPCS codes were used to identify admissions and patients who had undergone vertebral augmentation (VA).

Results

There were a total of 99,240 patients (61% Female) admitted during this period, with 64,370 (65%) patients aged 75 and over. On average, there was a 14.3% increase in admissions annually. The increasing trend was more notable in those aged 75 years and over. Patients aged over 75 years accounted for 1.5 million bed days, costing £465million (median length of stay (MLOS) 14.4 days). In comparison, those aged 55-74 years, accounted for 659,000 bed days, costing £239 million (MLOS 10.7 days). The majority of patients (84%) were admitted under a non-surgical speciality and were primarily older (median age 76.8 vs 67.6 years, MLOS 8.2 vs 6.0 days). 1755 patients underwent VA (1.8% of the total cohort). 775 (44.2%) of these were aged 75 years and over. The MLOS and cost per patient admission was lower in the VA group compared to those managed non-surgically (MLOS 2.4 vs 10.8 days, p=<0.01, cost £4737 vs £7250)

Conclusion

Patients aged 75 years and over hospitalised with VFF represented a significant number, cost, use of bed days and associated longer MLOS. Those undergoing VA had a significantly shorter length of stay. Further studies are necessary to identify older patients with VFF who may benefit from early VA.