Table 3.
Comparison of patients who received kyphoplasty to propensity matched patients who did not receive augmentation. Exact match on opioids and advanced imaging between fracture and kyphoplasty/pseudo-kyphoplasty (control group 2)
| Variable | No Augmentation n = 37,938 (50%) n (%) |
Kyphoplasty n = 37,938 (50%) n (%) |
Total n = 75,876 |
|---|---|---|---|
| Age (Median, IQR) | 80.7 (74.1, 87.2) | 80.5 (74.4, 86.4) | 80.6 (74.2, 86.8) |
| Female | 31,726 (84) | 30,823 (81) | 62,549 (82) |
| Patient race | |||
| Unknown | 210 (1) | 229 (1) | 439 (1) |
| White | 35,159 (93) | 35,384 (93) | 70,543 (93) |
| Black | 640 (2) | 530 (1) | 1170 (2) |
| Other | 466 (1) | 413 (1) | 879 (1) |
| Asian | 853 (2) | 785 (2) | 1638 (2) |
| Hispanic | 497 (1) | 483 (1) | 980 (1) |
| North American Native | 113 (0) | 114 (0) | 227 (0) |
| Year of Fracture | |||
| 2017 | 13,762 (36) | 14,007 (37) | 27,769 (37) |
| 2018 | 12,909 (34) | 12,864 (34) | 25,773 (34) |
| 2019 | 11,267 (30) | 11,067 (29) | 22,334 (29) |
| Charlson Co-morbidity Score (Median, IQR) | 2 (1–3) | 2 (1–3) | 2 (1–3) |
| 0 | 8715 (23) | 8800 (23) | 17,515 (23) |
| 1 | 8653 (23) | 8949 (24) | 17,602 (23) |
| 2–3 | 11,451 (30) | 11,323 (30) | 22,774 (30) |
| 4–5 | 5504 (15) | 5321 (14) | 10,825 (14) |
| 6 + | 3615 (10) | 3545 (9) | 7160 (9) |
| Comorbidities in year prior to fracture | |||
| Congestive heart failure | 9628 (25) | 9578 (25) | 19,206 (25) |
| Dementia | 4702 (12) | 4041 (11) | 8743 (12) |
| Renal failure | 6989 (18) | 6914 (18) | 13,903 (18) |
| Weight loss | 3128 (8) | 3089 (8) | 6217 (8) |
| Hemiplegia | 515 (1) | 468 (1) | 983 (1) |
| Alcohol abuse | 208 (1) | 234 (1) | 442 (1) |
| Cardiac arrhythmias | 14,891 (39) | 14,870 (39) | 29,761 (39) |
| Chronic pulmonary disease | 12,848 (34) | 13,174 (35) | 26,022 (34) |
| Coagulopathy | 2126 (6) | 2119 (6) | 4245 (6) |
| Complicated diabetes | 6297 (17) | 6338 (17) | 12,635 (17) |
| Deficiency anemia | 10,768 (28) | 10,393 (27) | 21,161 (28) |
| Fluid/electrolyte disorders | 8618 (23) | 8398 (22) | 17,016 (22) |
| Liver disease | 2284 (6) | 2332 (6) | 4616 (6) |
| Peripheral vascular disease | 10,132 (27) | 9693 (26) | 19,825 (26) |
| Mood disorders | 8729 (23) | 8290 (22) | 17,019 (22) |
| Pulmonary circulation disorders | 2746 (7) | 2816 (7) | 5562 (7) |
| HIV/AIDS | 29 (0) | 29 (0) | 58 (0) |
| Hypertension | 29,654 (78) | 29,644 (78) | 59,298 (78) |
| Myocardial infarction | 1961 (5) | 1868 (5) | 3829 (5) |
| Cardiovascular disease | 8203 (22) | 7784 (21) | 15,987 (21) |
| Rheumatic disease | 3763 (10) | 3598 (9) | 7361 (10) |
| Peptic ulcer disease | 896 (2) | 924 (2) | 1820 (2) |
| Diabetes without complications | 9402 (25) | 9394 (25) | 18,796 (25) |
| Frailty Score a | 9.7 (5.0–16.8) | 9.1 (4.7–15.7) | 9.4 (4.8–16.2) |
| Intermediate/High Frail Score | 28,506 (75) | 27,8218 (73) | 56,327 (74) |
| Admitted for fracture | 11,243 (30) | 9307 (25) | 20,550 (27) |
| Filled ≥ 1 medication from 90 days prior—fracture date | |||
| Opioid | 15,001 (40) | 14,840 (39) | 29,841 (39) |
| Muscle relaxer | 4738 (12) | 5038 (13) | 9776 (13) |
| Gabapentin | 2897 (8) | 2620 (7) | 5517 (7) |
| Benzodiazepine | 4576 (12) | 4511 (12) | 9087 (12) |
| NSAID | 3056 (8) | 3057 (8) | 6113 (8) |
| Pregabalin | 3167 (8) | 2999 (8) | 6166 (8) |
| Inpatient encounters in year prior to fracture (Median, IQR) | 0 (0, 1) | 0 (0, 1) | 0 (0, 1) |
| Outpatient encounters in year prior to fracture (Median, IQR) | 5 (2, 10) | 5 (2, 10) | 5 (2, 10) |
| Fracture Level | |||
| Lumbar | 18,804 (50) | 18,403 (49) | 37,207 (49) |
| Thoracic | 12,484 (33) | 12,387 (33) | 24,871 (33) |
| Thoracolumbar or Unspecified | 6650 (18) | 7148 (19) | 13,798 (18) |
| Patient had buy-in from state b | 6778 (18) | 6026 (16) | 12,804 (17) |
| Received advanced imaging in from 6 weeks prior to index fracture through kyphoplasty/pseudo-kyphoplasty | 35,782 (94) | 35,781 (94) | 71,562 (94) |
| Filled prescription for opioid from index fracture through kyphoplasty/pseudo-kyphoplasty | 14,381 (38) | 14,381 (38) | 28,762 (38) |
| Complications between index fracture and kyphoplasty/pseudo-kyphoplasty | |||
| Cardiac arrest | 60 (0) | 35 (0) | 95 (0) |
| Acute myocardial infarction | 506 (1) | 318 (1) | 824 (1) |
| Respiratory failure | 612 (1) | 381 (1) | 993 (1) |
| Pulmonary embolism | 288 (1) | 295 (1) | 583 (1) |
| Pneumonia | 2003 (5) | 1602 (4) | 3605 (5) |
| Stroke | 1171 (3) | 686 (2) | 1857 (2) |
| CPR | 19 (0) | 9 (0) | 28 (0) |
| Intubation | 164 (0) | 70 (0) | 234 (0) |
| Ventilator | 223 (1) | 85 (0) | 308 (0) |
| Deep vein thrombosis | 452 (1) | 378 (1) | 830 (1) |
| Hip fracture | 1438 (4) | 460 (1) | 1898 (3) |
| Paralysis | 350 (1) | 160 (0) | 510 (1) |
| Weight Loss | 2019 (5) | 1541 (4) | 3560 (5) |
| Liver Disease | 1046 (3) | 1072 (3) | 2118 (3) |
| HIV/AIDS | 11 (0) | 15 (0) | 26 (0) |
| Coagulopathy | 1288 (3) | 1250 (3) | 2538 (3) |
| Fluid and electrolyte disorders | 6578 (17) | 5980 (16) | 12,558 (17) |
| Sepsis | 986 (3) | 561 (1) | 1547 (2) |
| Gastrointestinal bleed | 400 (1) | 366 (1) | 766 (1) |
| Any complication | 11,485 (30) | 10,176 (27) | 21,661 (29) |
| Days from fracture to kyphoplasty (Median, IQR) | – | 13 (4, 31) | 13 (4, 31) |
| Days of follow-up after kyphoplasty/pseudo-kyphoplasty (Median, IQR) | 442 (196, 726) | 467 (217, 747) | 453 (207, 734) |
| Death prior to matched pair receiving kyphoplasty | 0 | – | 0 |
a
Frail score derived from Gilbert et al.[23]
b
Patients whose states (including state Medicaid programs) paid their monthly premiums
HIV/AIDS Human immunodeficiency virus/acquired immunodeficiency syndrome, IQR Interquartile range, NSAID Non-steroidal anti-inflammatory drug