Utilization and economic burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Abstract Background Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for osteoporotic vertebral compression fractures.Objective To evaluate PVP/PKP utilization and their related costs for OVCF treatment in China.Methods A population-based medical claims database of a metropolitan city in China was analyzed, which included all inpatient claims from 01/01/2015 to 31/12/2017. Eligible patients were 50 years or older, diagnosed with vertebral fractures with/without osteoporosis, and received PVP/PKP. Survival analysis function was used to estimate time to re-surgery and non-parametric statistical tests were used for comparison of cost and re-surgery rate between PVP and PKP.Results Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; and females accounted for 79.54% of all cases. Median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference of re-surgery rate between PVP and PKP (p=0.3897). Median time to the re-surgery was 139 days. Mean cost per PVP/PKP-related hospitalization was 35,906 CNY (34,195 CNY for PVP, 44,414 CNY for PKP, p<0.01). The overall cost of hospitalization averaged 186.61 million CNY (26.97 million USD) per year in this metropolitan city.Conclusion From 2015 to 2017, nearly one third of OVCF inpatients received PVP/PKP and re-surgery rate was high. PKP/PVP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis is critical in China.