Hospital Readmissions After Vertebral Fracture in Older Adults: A Comparison of Management Strategies

BACKGROUND: Osteoporotic vertebral fractures are common in older adults and are associated with pain, impaired mobility, and increased healthcare utilization. Balloon kyphoplasty and vertebroplasty are minimally invasive treatment options, but their association with short-term hospital utilization is less clear. This study evaluated whether treatment modality, age, and body mass index are associated with 30-day hospital return among adults aged 75 years and older hospitalized with vertebral fractures. METHODS: This retrospective secondary analysis used a quality improvement database from a community-based teaching hospital and included admissions from 2017 to 2023 for patients aged 75 years and older with a primary diagnosis of vertebral fracture. Patients who died during hospitalization or were discharged to hospice were excluded. Patients were grouped by treatment: balloon kyphoplasty, vertebroplasty, or conservative management. The primary outcome was hospital return within 30 days, defined as a post-discharge event resulting in readmission, emergency department visit, or observation stay. Descriptive statistics, chi-square and t-tests, and logistic regression were used to evaluate associations between treatment type, body mass index, age, and 30-day hospital return, with statistical significance set at p < 0.05. RESULTS: There was no statistically significant difference in 30-day hospital return between patients treated with balloon kyphoplasty or vertebroplasty and those managed conservatively. Body mass index and age were not significant predictors of 30-day hospital return in this cohort. A subset of admissions had missing body mass index values, including two patients in the balloon kyphoplasty or vertebroplasty group who did not return, and 58 patients in the conservative management group who did not return. CONCLUSIONS: Among adults aged 75 years and older hospitalized with vertebral fracture, balloon kyphoplasty and vertebroplasty were not associated with lower 30-day hospital return compared with conservative management. In this dataset, neither body mass index nor age meaningfully predicted short-term hospital return, suggesting that factors beyond these patient characteristics and initial treatment modality may drive early utilization after discharge.