Predictors of Vertebroplasty Selection in Older Adults with Osteoporotic Vertebral Compression Fractures: A...

The aim of the study was to identify demographic, clinical, and institutional predictors influencing the selection of percutaneous vertebroplasty (PVP) versus conservative management in older adults with osteoporotic vertebral compression fractures (OVCFs).

We conducted a retrospective cohort study using the Kaohsiung Medical University Hospital Research Database, including 1688 patients aged ≥50 years hospitalized for OVCFs (2018-2022). Patients were categorized into PVP (n = 385) and conservative management (n = 1,303) groups. Independent predictors of treatment selection were identified using multivariable logistic regression.

Significant predictors of vertebroplasty selection included advanced age (≥85 years), severe pain (VAS 8-10), congestive heart failure, diabetes mellitus, and analgesic usage, while a higher comorbidity burden (CCI ≥2) reduced the likelihood of receiving PVP. Regional hospitals were more likely than medical centers to perform vertebroplasty.

Patient age, pain severity, specific comorbidities, analgesic requirements, and institutional factors significantly influenced treatment selection for OVCFs. These findings underscore the need for individualized, risk-adapted strategies. Given the retrospective design, causal inferences should be interpreted with caution.