Background To explore the national inpatient trends, regional variations, associated diagnoses, and outcomes of vertebral augmentation (vertebroplasty and kyphoplasty) in the USA from 2004 to 2017.
Methods Data from the National Inpatient Sample were used to study hospitalization records for percutaneous vertebroplasty and kyphoplasty. Longitudinal projections of trends and outcomes, including mortality, post-procedural complications, length of stay, disposition, and total hospital charges were analyzed.
Results Following a period of decreased utilization from 2008 to 2012, hospitalizations for vertebroplasty and kyphoplasty plateaued after 2013. Total hospital charges and overall financial burden of hospitalizations for vertebroplasty and kyphoplasty increased to a peak of $1.9 billion (range $1.7–$2.2 billion) in 2017. Overall, 8% of procedures were performed in patients with a history of malignancy. In multivariable modeling, lung cancer (adjusted OR (aOR) 2.6 (range 1.4–5.1)) and prostate cancer (aOR 3.4 (range 1.2–9.4)) were associated with a higher risk of mortality. The New England region had the lowest frequency of routine disposition (14.1±1.1%) and the lowest average hospital charges ($47 885±$1351). In contrast, 34.0±0.8% had routine disposition in the West Central South region, and average hospital charges were as high as $99 836±$2259 in the Pacific region. The Mountain region had the lowest number of procedures (5365±272) and the highest mortality rate (1.2±0.3%).
Conclusion National inpatient trends of vertebroplasty and kyphoplasty utilization remained stable after a period of decline from 2008 to 2012, while the financial burden of hospitalizations increased. Despite recent improvements in outcomes, significant regional variations persisted across the USA.
Data availability statement
Data are available upon reasonable request. Data from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, United States Department of Health and Human Service.
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Contributors All authors approved the final version of the article, including the authorship list. Conception and design: NH-N, CRB and CRW; analysis and interpretation of the data (NH-N, CRB, MK, and CRW); drafting of the article (NH-N, AJS and MAA); critical revision of the article for important intellectual content (NH-N, CRB, AJS, MAA, JAC, MK and CRW); final approval of the article (NH-N, CRB, AJS, MAA, JAC, MK and CRW).
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer Unrelated to this project: Dr Carrino has received consulting fee from Pfizer, Inc, Covera, IAG, Image Biopsy Lab, and Simplify Medical, and is a member of scientific advisory board/other office of IAG. Dr Khan is consultant for Stryker Medical and Medwaves Avecure Medical Corporation. Dr Weiss has received research grants from Siemens Healthcare, Merit Medical, Medtronic, and BTG and is a consultant for BTG and Medtronic.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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