Relationship between preoperative glucose level and all-cause mortality in patients with osteoporotic vertebral compression fracture who underwent percutaneous vertebroplasty

Yu-Hsien Lin ^1,2, Yu-Tsung Lin ², Yun-Che Wu ²

¹Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
²Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
³Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁴Department of Computer Science and Information Engineering, Providence University, Taichung, Taiwan.
⁵Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing, and Management,, Miaoli, Taiwan.
⁶Department of Food Science and Technology, Hung Kuang University, Taichung, Taiwan.
⁷Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁸Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. jswang@vghtc.gov.tw.
⁹Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. jswang@vghtc.gov.tw.
¹⁰Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. jswang@vghtc.gov.tw.

⁰Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Scientific Reports +

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August 31, 2024

View abstract on PubMed

Summary

High preoperative blood glucose levels, not diabetes history, predict long-term mortality in osteoporotic vertebral compression fracture patients undergoing vertebroplasty. This finding emphasizes glucose control for better surgical outcomes.

Area Of Science

Geriatric Medicine
Orthopedic Surgery
Endocrinology

Background

Osteoporotic vertebral compression fractures (OVCF) are common in aging populations.
Percutaneous vertebroplasty (VP) is a common treatment for OVCF.
The impact of preoperative glycemic status on long-term outcomes after VP for OVCF is not well-established.

Purpose Of The Study

To investigate the association between preoperative blood glucose levels and long-term all-cause mortality in patients with OVCF treated with VP.
To determine if preoperative hyperglycemia is an independent risk factor for mortality in this patient cohort.

Main Methods

Single-center retrospective chart review of 131 patients undergoing VP for OVCF (2013-2020).
Exclusion criteria included pathological fractures, multiple fractures, and lack of bone mineral density assessment.
Cox proportional hazard models with multivariate adjustments were used to analyze the relationship between glucose levels and all-cause mortality, with survival status confirmed in March 2021.

Main Results

Preoperative hyperglycemia and elevated glucose levels were independently associated with a higher risk of all-cause mortality (HR 2.668, p=0.036 and HR 1.007, p=0.006, respectively).
These associations remained significant after adjusting for age, sex, and other comorbidities.
A history of diabetes mellitus was not a significant predictor of long-term mortality.

Conclusions

Preoperative glucose levels, particularly hyperglycemia, are significant independent risk factors for long-term all-cause mortality in patients with OVCF undergoing VP.
Diabetes mellitus history alone was not associated with increased mortality in this population.
These findings underscore the importance of managing preoperative glycemic control in elderly patients undergoing VP for OVCF.

Keywords:

All-cause mortality Blood glucose DM Osteoporotic vertebral compression fracture Percutaneous vertebroplasty