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Trends in hospitalizations for vertebral compression fracture in ankylosing spondylitis: data from the National Inpatient Sample 2000–2014

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Abstract

Ankylosing spondylitis (AS) patients are at increased risk of vertebral compression fractures (VCF). Our objective was to examine the yearly trend of VCF hospitalizations in AS patients as compared to rheumatoid arthritis (RA) and the general population. National Inpatient Sample (NIS) database (2000–2014) was used to identify adult (≥ 18 years) hospitalizations, based on validated ICD-9 diagnosis codes. The rate of VCF hospitalizations, as a primary diagnosis, was assessed in three mutually exclusive groups: AS, RA, and the general population. The prevalence of VCF hospitalization was highest in AS (2.70%), compared to 0.77% in RA and 0.35% in the general population. Over the 15-year period, VCF hospitalization in AS was noted to have an increasing trend (Annual Percent Change (APC) = 4.73, p < 0.05) in contrast to the stable trend in the general population (APC = 0.34, p = NS) and a declining trend in RA (APC -3.61, p < 0.05). VCF related to AS was also associated with a longer hospital stay as compared to the general population (8.1 days vs. 5.1 days, p < 0.05) and higher inpatient mortality (3.4% vs. 1.0%, p < 0.05). A higher rate of VCF hospitalization along with an increasing trend was noted in AS as compared to RA and compared to the general population. Better screening approaches and treatment strategies for AS patients with VCF risk are urgently needed to reduce hospitalizations and related complications.

Key Points

• An increasing trend of VCF hospitalization was noted in AS, in contrast to a declining trend in RA and a stable trend in the general population.

• VCF in AS was associated with longer hospital stay and higher inpatient mortality than in RA and the general population.

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Funding

Dr. Karmacharya is supported by T32 AR56950 grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases for the Musculoskeletal Research Training Program, Spondyloarthritis Research and Treatment Network (SPARTAN) fellowship pilot grant, and Assessment of spondyloarthritis international society (ASAS) fellowship grant.

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Authors and Affiliations

  1. Internal Medicine, Reading Hospital and Medical Center, West Reading, PA, USA

    Rashmi Dhital, Ibiyemi Oke, Anthony Donato & Anish Paudel

  2. Rheumatology, University of Pennsylvania, Philadelphia, PA, USA

    Dilli Ram Poudel

  3. Internal Medicine, University of Massachusetts, Worcester, MA, USA

    Prakash Paudel

  4. Division of Rheumatology, Mayo Clinic, Rochester, MN, USA

    Paras Karmacharya

  5. Division of Rheumatology, Vanderbilt University, Nashville, TN, USA

    Paras Karmacharya

Authors
  1. Rashmi Dhital
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  2. Ibiyemi Oke
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  3. Anthony Donato
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  4. Anish Paudel
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  5. Dilli Ram Poudel
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  6. Prakash Paudel
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  7. Paras Karmacharya
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Contributions

Study conception and design- RD, PK. Data analysis- RD, AP. Original draft preparation- RD, IO, PP. Review and editing- DRP, AD, PK. All authors approved the final version of the manuscript to be submitted.

Corresponding author

Correspondence to Rashmi Dhital.

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Ethics approval and consent to participate

Data obtained from National Inpatient Sample (NIS) database. NIS only contains de-identified data and is thus exempt from institutional review board approval in concordance with the formal HCUP data use agreement.

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Not applicable.

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None.

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Paudel A, Dhital R, Poudel D, Donato A, Karmacharya P. Trends in Hospitalizations for Vertebral Compression Fractures in Ankylosing Spondylitis: Data from the National Inpatient Sample 2001-2014 [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/trends-in-hospitalizations-for-vertebral-compression-fractures-in-ankylosing-spondylitis-data-from-the-national-inpatient-sample-2001–2014

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Dhital, R., Oke, I., Donato, A. et al. Trends in hospitalizations for vertebral compression fracture in ankylosing spondylitis: data from the National Inpatient Sample 2000–2014. Clin Rheumatol 40, 4927–4932 (2021). https://doi.org/10.1007/s10067-021-05842-0

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