The cost-effectiveness of percutaneous kyphoplasty vs conservative treatment for elderly osteoporsis vertebral compression fracture

English Keywords:Senile osteoporsis vertebral compression fracture  Percutaneous kyphoplasty  Conservative treatment  Cost-effectiveness evaluation

English Abstract:

  【Abstract】 Objectives: To analyze the clinical effects of non operation treatment and percutaneous kyphoplasty(PKP) for elderly osteoporosis vertebral compression fracture(OVCF) and provide basic-consideration for optimum planning of operation for clinicians. Methods: 134 elderly OVCF patients were admitted into our institute, including 67 patients in operation group and 67 patients in conservative treatment who were selected from May 2010 to February 2011. All the patients were informed consent and volunteered to be in groups. Cost-effectiveness evaluation, dividing clinical effectiveness(E) by the whole cost of two groups during period of hospitalization, outpatient follow-ups and the whole treatment, was undertaken to get cost-effectiveness ratio(C/E). Compared between groups, to evaluate cost-effectiveness at 1 year after discharge(clinical cost), used the average cost(△C) of clinical treatment based on financial accounting; and obtained the situation of symptoms improvement(△E) between the scores of two time points based on ADL scores during period of hospitalization or follow-ups of VAS scores after discharge. The △C/△E was calculated. Obtaining the treating cost and unitization to get the whole clinical effect by research, which could calculate the cost of unit efficacy of different treatment methods. Cost-effectiveness of two methods were calculated according to proportion of clinical effect "complete normal"(ADL scores≤16 or VAS scores≤2) or proportion of "function improvement"(ADL scores from 17 to 21 or VAS scores from 3 to 8). Results: If "complete normal" was used as the standard of effect evaluation, the cost-effectiveness of surgical treatment group(C/E) was 902.93, the conservative group was 4072.56, PKP was superior to conservative treatment(P<0.05); If "function improvement" was used as the standard of effect evaluation, the cost-effectiveness of surgical treatment group(C/E) was 372.70, the conservative group was 194.86, conservative treatment was superior to PKP(P<0.05). The cost-effectiveness of treatment cost after discharge indicated that the surgical group was 2.88, conservative group was 5.63, PKP was superior to conservative treatment group(P<0.05). Conclusions: The result of cost-effectiveness analysis indicates that, if enhancing the quality of life was the goal, PKP was superior to conservative treatment; if the goal was "function improvement", non surgical treatment was superior to PKP; On the cost of treating cost after discharge, PKP was less than conservative treatment.