Abstract：
METHODS: Retrospective cohort study.
OBJECTIVE: Geriatric vertebral compression fractures are the most common fracture associated with osteoporosis. Using a large national database, the current study aimed to examine and characterize bracing trends for geriatric thoracic/lumbar compression fracture management.
METHODS: The current study utilized the PearlDiver database from 2015-2021. Patients who suffered thoracic/lumbar compression fractures (fifth thoracic to the fifth lumbar vertebra [T5-L5]) were identified. Exclusion criteria included patients less than 65 years old or an indication of infection or neoplasm. Patients who received a brace within 90-days after the initial diagnosis of thoracic/lumbar compression fracture were abstracted and characterized overall and by fracture level. Multivariable logistic regression was performed to assess for correlation with bracing trends.
RESULTS: In total 290 388 patients met inclusion criteria and suffered a thoracic/lumbar compression fracture (greatest incidence at the thoracolumbar junction). Of these, bracing was only prescribed for 4263 (1.5%), with the greatest variance of 1.5% by level. Independent predictors of bracing were geographic region (relative to northeast, west WE odds ratio [OR] 1.31, Midwest OR 1.20), younger age (OR 1.27 per decade), female sex (OR 1.17), and ECI (OR 1.02 per 2-point increase) (P < .05 for each).
CONCLUSIONS: Overall, the current study examined over a quarter of a million patients who suffered a T5-L5 compression fractures and found that only 1.5% of patients were braced. This low percentage, and that greatest predictor for bracing was non-clinical (geographic region), highlight the inconsistency of this practice and may be useful for developing treatment algorithms.
OBJECTIVE: Geriatric vertebral compression fractures are the most common fracture associated with osteoporosis. Using a large national database, the current study aimed to examine and characterize bracing trends for geriatric thoracic/lumbar compression fracture management.
METHODS: The current study utilized the PearlDiver database from 2015-2021. Patients who suffered thoracic/lumbar compression fractures (fifth thoracic to the fifth lumbar vertebra [T5-L5]) were identified. Exclusion criteria included patients less than 65 years old or an indication of infection or neoplasm. Patients who received a brace within 90-days after the initial diagnosis of thoracic/lumbar compression fracture were abstracted and characterized overall and by fracture level. Multivariable logistic regression was performed to assess for correlation with bracing trends.
RESULTS: In total 290 388 patients met inclusion criteria and suffered a thoracic/lumbar compression fracture (greatest incidence at the thoracolumbar junction). Of these, bracing was only prescribed for 4263 (1.5%), with the greatest variance of 1.5% by level. Independent predictors of bracing were geographic region (relative to northeast, west WE odds ratio [OR] 1.31, Midwest OR 1.20), younger age (OR 1.27 per decade), female sex (OR 1.17), and ECI (OR 1.02 per 2-point increase) (P < .05 for each).
CONCLUSIONS: Overall, the current study examined over a quarter of a million patients who suffered a T5-L5 compression fractures and found that only 1.5% of patients were braced. This low percentage, and that greatest predictor for bracing was non-clinical (geographic region), highlight the inconsistency of this practice and may be useful for developing treatment algorithms.
摘要：
方法：回顾性队列研究。
目的：老年椎体压缩性骨折是最常见的与骨质疏松相关的骨折。使用大型国家数据库，本研究旨在研究和表征老年胸/腰椎压缩性骨折治疗的支撑趋势.
方法：当前的研究利用了2015-2021年的PearlDiver数据库。确定了患有胸/腰椎压缩性骨折（第五胸椎至第五腰椎[T5-L5]）的患者。排除标准包括年龄小于65岁或有感染或肿瘤指征的患者。在最初诊断为胸/腰椎压缩性骨折后90天内接受支具的患者被提取并表征为整体和骨折水平。进行多变量逻辑回归以评估与支撑趋势的相关性。
结果：总共290.388例患者符合纳入标准，患有胸/腰椎压缩性骨折（胸腰椎交界处的发病率最高）。其中,仅对4263人(1.5%)规定了支撑，按级别划分的最大方差为1.5%。支撑的独立预测因素是地理区域(相对于东北部，西部WE赔率比[OR]1.31，中西部OR1.20)，年龄较小（每十年1.27岁），女性（OR1.17），和ECI（每增加2个点OR1.02）（每个P<0.05）。
结论：总体而言，目前的研究检查了超过25万名T5-L5压缩性骨折患者，发现只有1.5%的患者接受了支撑。这么低的百分比,支撑的最大预测指标是非临床(地理区域)，强调这种做法的不一致，可能有助于开发治疗算法。
目的：老年椎体压缩性骨折是最常见的与骨质疏松相关的骨折。使用大型国家数据库，本研究旨在研究和表征老年胸/腰椎压缩性骨折治疗的支撑趋势.
方法：当前的研究利用了2015-2021年的PearlDiver数据库。确定了患有胸/腰椎压缩性骨折（第五胸椎至第五腰椎[T5-L5]）的患者。排除标准包括年龄小于65岁或有感染或肿瘤指征的患者。在最初诊断为胸/腰椎压缩性骨折后90天内接受支具的患者被提取并表征为整体和骨折水平。进行多变量逻辑回归以评估与支撑趋势的相关性。
结果：总共290.388例患者符合纳入标准，患有胸/腰椎压缩性骨折（胸腰椎交界处的发病率最高）。其中,仅对4263人(1.5%)规定了支撑，按级别划分的最大方差为1.5%。支撑的独立预测因素是地理区域(相对于东北部，西部WE赔率比[OR]1.31，中西部OR1.20)，年龄较小（每十年1.27岁），女性（OR1.17），和ECI（每增加2个点OR1.02）（每个P<0.05）。
结论：总体而言，目前的研究检查了超过25万名T5-L5压缩性骨折患者，发现只有1.5%的患者接受了支撑。这么低的百分比,支撑的最大预测指标是非临床(地理区域)，强调这种做法的不一致，可能有助于开发治疗算法。
