Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review

Hyun jin Jang; So jeong Kim; Min Ju Kim; Hyeon Kyu Choi; Pil Je Park; Kang Yeon soo; Jeong Kyo Jeong; Ju Hyun Jeon; Young Il Kim; Jang, Hyun jin; Kim, So jeong; Kim, Min Ju; Choi, Hyeon Kyu; Park, Pil Je; soo, Kang Yeon; Jeong, Jeong Kyo; Jeon, Ju Hyun; Kim, Young Il

doi:10.13048/jkm.23022

JKM > Volume 44(2); 2023 > Article

Jang, Kim, Kim, Choi, Park, soo, Jeong, Jeon, and Kim: Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review

Original Article

The Journal of Korean Medicine 2023; 44(2): 149-169.

DOI: https://doi.org/10.13048/jkm.23022

Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review

, Min Ju Kim

, Pil Je Park

, Young Il Kim^*

Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea

Correspondence to: Young Il Kim 75, Daedeok-daero 176beon-gil, Seo-gu, Daejeon, Republic of Korea Tel: +82-42-470-9137, Fax: +82-42-470-9008, Email: omdkim01@dju.kr

Received April 20, 2023 Revised May 7, 2023 Accepted May 10, 2023

Abstract

Objectives

This study was designed to statistically analyze patients hospitalized for thoracolumbar compression fractures at Daejeon University Daejeon Korean Medicine Hospital from January 1, 2017 to December 31, 2021.

Methods

A total of 62 patients were analyzed through electronic medical records in this study. The extracted data was analyzed using IBM SPSS ver.27.0.

Results

Traffic accident patients were more likely to reduce pain by more than half compared to falls and other patients. Patients without spinal disease were more likely to reduce pain by more than half compared to those without. The shorter the absolute bed rest and the longer the hospital stay, the higher the probability of pain reduction by more than half.
The duration of pain half-reduction was longer in patients with diabetes than in patients without diabetes.
The longer the hospitalization period and the shorter the absolute bed rest period, the less pain was reported upon discharge. Males complained of less pain at discharge than females, and patients without spinal disease complained less than those without. Patients who did not receive absolute bed rest complained of less pain upon discharge than those who did not.

Conclusions

This study included patients hospitalized for thoracolumbar compression fractures and showed that etiology, absolute bed rest period, hospitalization period, gender, spinal disease, diabetes statistically affected the degree of pain reduction.

Keywords: Thoracolumbar compression fracture, Hospitalized patients, Korean medicine treatment, NRS, Retrospective observational study

Fig. 1

Study flow chart

Table 1

Frequency Analysis of Demograhic Variables

Variables		Number of patients	%
Sex	Male	12	19.4
Sex	Female	50	80.6

Age	1–29	2	3.2
	30–39	2	3.2
	40–49	6	9.7
	50–59	12	19.4
	60–69	13	21.0
	70-	27	43.5
	Mean±SD	64.18±15.462

Past history	Hypertension	24	38.7
	Diabetes Mellitus	8	12.9
	Hyperlipidemia	9	14.5
	Osteoporosis	12	19.4
	Spinal disease	7	11.3
	Fracture	13	21.0

Table 2

Frequency Analysis of Disease Variables

Variables		Number of patients	%
Motive for fracture	Traffic accident	38	61.3
	Fall down	21	33.9
	et al.	3	4.8

Fracture site	T1	0	0
	T2	2	3.2
	T3	2	3.2
	T4	5	8.1
	T5	0	0
	T6	3	4.8
	T7	3	4.8
	T8	2	3.2
	T9	2	3.2
	T10	4	6.5
	T11	6	9.7
	T12	16	25.8
	L1	13	21.0
	L2	7	11.3
	L3	9	14.5
	L4	6	9.7
	L5	3	4.8

Fracture site(thoracolumbar)	T-spine	28	45.2
	L-spine	32	51.6
	Both T,L-spine	2	3.2

Number of fractures	1 level only	45	72.6
	2 levels	13	21.0
	3 levels	3	4.8
	4 levels	1	1.6
	Mean±SD	1.35±0.655

Comorbid fracture	Yes	16	25.8
Comorbid fracture	No	46	74.2

Diagnosis at another medical institutions	Yes	55	88.7
Diagnosis at another medical institutions	No	7	3.2

Operation	Yes	7	11.3
Operation	No	55	88.7

Table 3

Frequency Analysis of Therapeutic Variables

Variables		Number of patienst	%
Days from onset to hospitalization	1 week or less	14	22.6
	1–2weeks	8	12.9
	2–3weeks	13	21.0
	3–4weeks	5	8.1
	4–5weeks	9	14.5
	5–6weeks	5	8.1
	6–7weeks	1	1.6
	7–8weeks	2	3.2
	More than 8 weeks	5	8.1
		24.65±23.892

Days from onset to discharge	1–2weeks	2	3.2
	2–3weeks	4	6.5
	3–4weeks	5	8.1
	4–5weeks	6	9.7
	5–6weeks	8	12.9
	6–7weeks	7	11.3
	7–8weeks	9	14.5
	8–9weeks	8	12.9
	9–10weeks	2	3.2
	10–11weeks	2	3.2
	11–12weeks	3	4.8
	More than 12 weeks	6	9.7
		50.35±24.557

Hospitalization period	1week of less	6	9.7
	1–2weeks	9	14.5
	2–3weeks	11	17.7
	3–4weeks	8	12.9
	4–5weeks	11	17.7
	5–6weeks	8	12.9
	6–7weeks	4	6.5
	7–8weeks	2	3.2
	More than 8 weeks	3	4.8
		26.69±15.929

Absolute bed rest period	no ABR	44	71.0
	1 week or less	7	11.3
	1–2weeks	6	9.7
	2–3weeks	4	6.5
	3–4weeks	1	1.6
		10.22±5.84

Taking analgesic	Yes	50	80.6
	No	12	19.4

Table 4

Frequency Analysis of Therapeutic Effect

Variables		Number of patients	%
Pain on the first day of hospitalization	*NRS2	1	1.6
	NRS3	1	1.6
	NRS4	19	30.6
	NRS5	6	9.7
	NRS6	23	37.1
	NRS7	9	14.5
	NRS8	3	4.8
	Mean±SD	5.42±1.32

Pain improvement rate at discharge	0~10%	7	11.3
	11~20%	7	11.3
	21~30%	8	12.9
	31~40%	6	9.7
	41~50%	5	8.1
	51~60%	4	6.5

	61~70%	8	12.9
	71~80%	6	9.7
	81~90%	2	3.2
	91~100%	7	11.3
	100%~	2	3.2

More than half reduction in pain	Yes	36	58.1
More than half reduction in pain	No	26	41.9

Days for pain to decrease by more than half	1week or less	16	25.8
	1–2weeks	6	9.7
	2–3weeks	6	9.7
	3–4weeks	5	8.1
	More than 4week	3	4.8
		13.92±12.516

* NRS: numeric rating scale

Table 5

Crossover Analysis of more than Half Reduction in Pain and Spinal Disease

Variables			Spinal disease		Total	χ²(p)

			No	Yes
More than half reduction in pain	No	N	20	6	26	6.211 (0.013*)
	No	%	76.9	23.1	100

	Yes	N	35	1	36
	Yes	%	97.2	2.8	100

Total			55(88.7)	7(11.3)	62

N: number of patients,

* p<0.05

Table 6

Crossover analysis of age and ABR

Variables			ABR		Total	χ²(p)

			Yes	No
Age	1~29	N	0	2	2	12.576 (0.028*)
	1~29	%	0.0	100.0	100.0

	30~39	N	0	2	2
	30~39	%	0.0	100.0	100.0

	40~49	N	1	5	6
	40~49	%	16.7	83.3	100.0

	50~59	N	1	11	12
	50~59	%	8.3	91.7	100.0

	60~69	N	2	11	13
	60~69	%	15.4	84.6	100.0

	70~	N	14	13	27
	70~	%	51.9	48.1	100.0

	Total		18(29.0)	44(71.0)	62

N: number of patients, ABR: absolute bed rest,

* p<0.05

Table 7

Independent Sample T-test of Diabetes Mellitus

Variables	Diabetes Mellitus	N	Mean	SD	t	p
Days for pain to decrease by more than half	Yes	6	25.83	16.534	−2.040	0.009**
Days for pain to decrease by more than half	No	30	11.53	10.328	−2.040	0.009**

N: number of patients,

** p<0.01,

*** p<0.001

Table 8

Independent Sample T-test of Spinal Disease

Variables	Spinal disease	N	Mean	SD	t	p
Pain improvement rate at discharge	Yes	7	7.43	1.813	−1.941	0.014*
Pain improvement rate at discharge	No	55	5.09	3.105	−1.941	0.014*

N: number of patients,

* p<0.05

Table 10

ANOVA of days form onset to discharge

Variables		Days from onset to discharge		F	p

		M	SD
Motive for fracture	Traffic accident	57.42^a	22.958	5.117	0.009**
	Fall down	40.95^ab	23.310
	et al.	26.67^b	22.143

Fracture site (thoracolumbar)	T-spine	53.14^a	4.593	8.580	<0.001***
	L-spine	44.25^a	3.389
	Both T,L-spine	109.00^b	24.000

T-spine: toracic spine, L-spine: lumbar spine, SD: standard deviation,

** p<0.01,

*** p<0.001

Table 11

Multiple Linear Regression Analysis of more than Half Reduction in Pain

	Categories	Unstandardized		Standardized	T	p	F (p-value)

		B	S.E	beta
Independent Variables	Constant	1.499	0.652		2.300	0.025	2.189 (0.043*)
	Age	−0.037	0.048	−0.100	−0.764	0.448
	Sex	−0.240	0.180	−0.192	−1.334	0.188
	Diabetes Mellitus	0.108	0.186	0.074	0.582	0.563
	Hyperlipidemia	0.138	0.179	0.099	0.772	0.442
	Hospitalization period	0.015	0.004	0.495	3.559	<0.001***
	Absolute bed rest period	−0.029	0.013	−0.330	−2.182	0.034*
	Motive for fracture	−0.291	0.125	−0.346	−2.325	0.024*
	Number of fractured vertebra	−0.095	0.109	−0.126	−0.873	0.386

Dependent variable: More than half reduction in pain

* p<0.05,

*** p<0.001

Table 12

Multiple Linear Regression Analysis of Pain Improvement Rate at Discharge

	Categories	Unstandardized		Standardized	T	p	F (p-value)

		B	S.E	beta
Independent Variables	Constant	−4.188	3.951		−1.060	0.294	2.286 (0.035*)
	Age	0.450	0.323	0.198	1.394	0.169
	Sex	2.255	1.103	0.293	2.045	0.046*
	Hospitalization period	−0.094	0.027	−0.488	−3.479	0.001***
	Absolute bed rest period	0.172	0.085	0.315	2.021	0.048*
	Number of fractured vertebra	0.815	0.684	0.174	1.192	0.239
	Motive for fracture	1.380	0.756	0.266	1.827	0.073
	Number of past history	−0.380	0.411	−0.135	−0.927	0.358
	Comorbid fracture	0.514	0.947	0.074	0.543	0.590

Dependent variable: Pain improvement rate at discharge

* p<0.05,

*** p<0.001

Table 13

Logistics Repression Analysis of more than Half Reduction in Pain

Variable		B	S.E	Wald	p	Exp(B)
Absolute bed rest period		−0.136	0.063	4.735	0.030*	0.873
Hospitalization period		0.077	0.025	9.503	0.002**	1.080
Number of fractured vertebral		−0.162	0.494	0.107	0.743	0.851

	et al.			3.996	0.136
Motive for fracture	Fall down	−0.895	1.415	0.400	0.527	0.409
	Traffic accident	−2.174	1.474	2.175	0.140	0.114
	Dependent variable: More than half reduction in pain Hosmer-Lemeshow χ²(p): 4.926(0.765)

* p<0.05,

** p<0.01

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