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Erschienen in: Archives of Osteoporosis 1-2/2013

01.12.2013 | Original Article

Clinical and economic characteristics of hip fracture patients with and without muscle atrophy/weakness in the United States

verfasst von: Yang Zhao, Shih-Yen Chen, Yuan-Chi Lee, Ning Wu

Erschienen in: Archives of Osteoporosis | Ausgabe 1-2/2013

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Abstract

Summary

This retrospective analysis of hip fracture patients with and without muscle atrophy/weakness (MAW) revealed that those with MAW had significantly higher healthcare utilization and costs compared with hip fracture patients without MAW.

Purpose

Examine the demographics, clinical characteristics, and healthcare resource utilization and costs of hip fracture patients with and without MAW.

Methods

Using a large US claims database, individuals who were newly hospitalized for hip fracture between 1 Jan 2006 and 30 September 2009 were identified. Patients aged 50–64 years with commercial insurance (Commercial) or 65+ years with Medicare supplemental insurance (Medicare) were included. The first hospitalization for hip fracture was defined as the index stay. Patients were categorized into three cohorts: patients with medical claims associated with MAW over the 12 months before the index stay (pre-MAW), patients whose first MAW claim occurred during or over the 12 months after the index stay (post-MAW), and patients without any MAW claim (no-MAW). Multivariate regressions were performed to assess the association between MAW and healthcare costs over the 12-month post-index period, as well as the probability of re-hospitalization.

Results

There were 26,122 Medicare (pre-MAW, 839; post-MAW, 2,761; no-MAW, 22,522) and 5,100 Commercial (pre-MAW, 132; post-MAW, 394; no-MAW, 4,574) hip fracture patients included in this study. Controlling for cross-cohort differences, both the pre-MAW and post-MAW cohorts had significantly higher total healthcare costs (Medicare, $7,308 and $18,753 higher; Commercial, $18,679 and $25,495 higher) than the no-MAW cohort (all p < 0.05) over the 12-month post-index period. The post-MAW cohort in both populations was also more likely to have any all-cause or fracture-related re-hospitalization during the 12-month post-index period.

Conclusions

Among US patients with hip fractures, those with MAW had higher healthcare utilization and costs than patients without MAW.
Literatur
1.
Zurück zum Zitat Bischoff-Ferrari HA (2011) The role of falls in fracture prediction. Curr Osteoporos Rep 9(3):116–121PubMedCrossRef Bischoff-Ferrari HA (2011) The role of falls in fracture prediction. Curr Osteoporos Rep 9(3):116–121PubMedCrossRef
2.
Zurück zum Zitat Bass E, French DD, Bradham DD, Rubenstein LZ (2007) Risk-adjusted mortality rates of elderly veterans with hip fractures. Ann Epidemiol 17(7):514–519PubMedCrossRef Bass E, French DD, Bradham DD, Rubenstein LZ (2007) Risk-adjusted mortality rates of elderly veterans with hip fractures. Ann Epidemiol 17(7):514–519PubMedCrossRef
3.
Zurück zum Zitat Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51(3):364–370PubMedCrossRef Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51(3):364–370PubMedCrossRef
4.
Zurück zum Zitat Hopley C, Stengel D, Ekkernkamp A, Wich M (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ 340:c2332–c2332, jun11 1PubMedCrossRef Hopley C, Stengel D, Ekkernkamp A, Wich M (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ 340:c2332–c2332, jun11 1PubMedCrossRef
5.
Zurück zum Zitat Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289PubMedCrossRef Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289PubMedCrossRef
6.
Zurück zum Zitat National Center for Health Statistics (US) (2010) “Health, United States, 2009; with special feature on medical technology,” National Center for Health Statistics (US), Hyattsville (MD) Jan National Center for Health Statistics (US) (2010) “Health, United States, 2009; with special feature on medical technology,” National Center for Health Statistics (US), Hyattsville (MD) Jan
8.
Zurück zum Zitat Butler M, Forte M, Kane R et al (2009) “Treatment of common hip fractures. Rockville (MD): Agency for Healthcare Research and Quality (US)”, Evidence reports/technology assessments vol. no. 184, Aug Butler M, Forte M, Kane R et al (2009) “Treatment of common hip fractures. Rockville (MD): Agency for Healthcare Research and Quality (US)”, Evidence reports/technology assessments vol. no. 184, Aug
9.
Zurück zum Zitat Creditor MC (1993) Hazards of hospitalization of the elderly. Ann Intern Med 118(3):219–223PubMedCrossRef Creditor MC (1993) Hazards of hospitalization of the elderly. Ann Intern Med 118(3):219–223PubMedCrossRef
10.
Zurück zum Zitat Visser M, Harris TB, Fox KM, Hawkes W, Hebel JR, Yahiro JY, Michael R, Zimmerman SI, Magaziner J (2000) Change in muscle mass and muscle strength after a hip fracture: relationship to mobility recovery. J Gerontol A Biol Sci Med Sci 55(8):M434–M440PubMedCrossRef Visser M, Harris TB, Fox KM, Hawkes W, Hebel JR, Yahiro JY, Michael R, Zimmerman SI, Magaziner J (2000) Change in muscle mass and muscle strength after a hip fracture: relationship to mobility recovery. J Gerontol A Biol Sci Med Sci 55(8):M434–M440PubMedCrossRef
11.
Zurück zum Zitat Bhave A, Marker DR, Seyler TM, Ulrich SD, Plate JF, Mont MA (2007) Functional problems and treatment solutions after total hip arthroplasty. J Arthroplasty 22(6 Suppl 2):116–124PubMedCrossRef Bhave A, Marker DR, Seyler TM, Ulrich SD, Plate JF, Mont MA (2007) Functional problems and treatment solutions after total hip arthroplasty. J Arthroplasty 22(6 Suppl 2):116–124PubMedCrossRef
12.
Zurück zum Zitat Rasch A, Byström AH, Dalén N, Martinez-Carranza N, Berg HE (2009) Persisting muscle atrophy two years after replacement of the hip. J Bone Joint Surg Br 91(5):583–588PubMedCrossRef Rasch A, Byström AH, Dalén N, Martinez-Carranza N, Berg HE (2009) Persisting muscle atrophy two years after replacement of the hip. J Bone Joint Surg Br 91(5):583–588PubMedCrossRef
13.
Zurück zum Zitat Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP (2008) The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol 61(12):1234–1240PubMedCrossRef Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP (2008) The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol 61(12):1234–1240PubMedCrossRef
14.
Zurück zum Zitat The Bureau of Labor Statistics, “Databases, tables & calculators by subject: inflation and prices” The Bureau of Labor Statistics, “Databases, tables & calculators by subject: inflation and prices”
15.
Zurück zum Zitat Greene W H (2002) Econometric analysis, 5th ed. Upper Saddle River, NJ, Prentice Hall Greene W H (2002) Econometric analysis, 5th ed. Upper Saddle River, NJ, Prentice Hall
16.
Zurück zum Zitat Afifi AA, Kotlerman JB, Ettner SL, Cowan M (2007) Methods for improving regression analysis for skewed continuous or counted responses. Annu Rev Public Health 28(1):95–111PubMedCrossRef Afifi AA, Kotlerman JB, Ettner SL, Cowan M (2007) Methods for improving regression analysis for skewed continuous or counted responses. Annu Rev Public Health 28(1):95–111PubMedCrossRef
17.
Zurück zum Zitat Efron B, Tibshirani R (1993) An introduction to the bootstrap. Boca Raton, FL, CRC Press Efron B, Tibshirani R (1993) An introduction to the bootstrap. Boca Raton, FL, CRC Press
18.
Zurück zum Zitat Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi D, Proia A, Russo A, Bernabei R, Onder G (2012) Prevalence and risk factors of sarcopenia among nursing home older residents. J Gerontol A Biol Sci Med Sci 67(1):48–55PubMedCrossRef Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi D, Proia A, Russo A, Bernabei R, Onder G (2012) Prevalence and risk factors of sarcopenia among nursing home older residents. J Gerontol A Biol Sci Med Sci 67(1):48–55PubMedCrossRef
19.
Zurück zum Zitat Wehren LE, Hawkes WG, Hebel JR, Orwig DL, Magaziner J (2005) Bone mineral density, soft tissue body composition, strength, and functioning after hip fracture. J Gerontol A Biol Sci Med Sci 60(1):80–84PubMedCrossRef Wehren LE, Hawkes WG, Hebel JR, Orwig DL, Magaziner J (2005) Bone mineral density, soft tissue body composition, strength, and functioning after hip fracture. J Gerontol A Biol Sci Med Sci 60(1):80–84PubMedCrossRef
20.
Zurück zum Zitat Fox KM, Magaziner J, Hawkes WG, Yu-Yahiro J, Hebel JR, Zimmerman SI, Holder L, Michael R (2000) Loss of bone density and lean body mass after hip fracture. Osteoporos Int 11(1):31–35PubMedCrossRef Fox KM, Magaziner J, Hawkes WG, Yu-Yahiro J, Hebel JR, Zimmerman SI, Holder L, Michael R (2000) Loss of bone density and lean body mass after hip fracture. Osteoporos Int 11(1):31–35PubMedCrossRef
21.
Zurück zum Zitat Centers for Disease Control and Prevention (2010) “National Hospital Discharge Survey: 2006 annual summary,” Vital and Health Statistics Number 168, Dec Centers for Disease Control and Prevention (2010) “National Hospital Discharge Survey: 2006 annual summary,” Vital and Health Statistics Number 168, Dec
22.
Zurück zum Zitat Pasoto S G, Yoshihara L A K, Maeda L C, Bernik M M S, Lotufo P A, Bonfa E, Pereira R M R (2011) “Osteoporotic hip fractures in non-elderly patients: relevance of associated co-morbidities,” Rheumatol. Int: Sep Pasoto S G, Yoshihara L A K, Maeda L C, Bernik M M S, Lotufo P A, Bonfa E, Pereira R M R (2011) “Osteoporotic hip fractures in non-elderly patients: relevance of associated co-morbidities,” Rheumatol. Int: Sep
23.
Zurück zum Zitat Heuberger RA (2011) The frailty syndrome: a comprehensive review. J Nutr Gerontol Geriatr 30(4):315–368PubMedCrossRef Heuberger RA (2011) The frailty syndrome: a comprehensive review. J Nutr Gerontol Geriatr 30(4):315–368PubMedCrossRef
24.
Zurück zum Zitat Topinková E (2008) Aging, disability and frailty. Ann Nutr Metab 52 Suppl 1:6–11PubMed Topinková E (2008) Aging, disability and frailty. Ann Nutr Metab 52 Suppl 1:6–11PubMed
25.
Zurück zum Zitat Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579PubMedCrossRef Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579PubMedCrossRef
26.
Zurück zum Zitat Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20(10):1633–1650PubMedCrossRef Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20(10):1633–1650PubMedCrossRef
27.
Zurück zum Zitat Bhattacharya A, Leigh JP (2011) Musculoskeletal disorder cots and medical claim filing in the US retail trade sector. Ind Heal 49:517–522CrossRef Bhattacharya A, Leigh JP (2011) Musculoskeletal disorder cots and medical claim filing in the US retail trade sector. Ind Heal 49:517–522CrossRef
28.
Zurück zum Zitat Wijnhoven HAH, de Vet HCW, Picavet HSJ (2006) Prevalence of musculoskeletal disorders is systematically higher in women than in men. Clin J Pain 22(8):717–724PubMedCrossRef Wijnhoven HAH, de Vet HCW, Picavet HSJ (2006) Prevalence of musculoskeletal disorders is systematically higher in women than in men. Clin J Pain 22(8):717–724PubMedCrossRef
29.
Zurück zum Zitat Burroughs K, Walker K (2012) “Hip fractures in adults,” UpToDate, no. Topic 226, Version 12.0 Burroughs K, Walker K (2012) “Hip fractures in adults,” UpToDate, no. Topic 226, Version 12.0
30.
Zurück zum Zitat Milken Institute, “An unhealthy America: the economic burden of chronic disease.” Santa Monica, CA, Milken Institute 2012 Milken Institute, “An unhealthy America: the economic burden of chronic disease.” Santa Monica, CA, Milken Institute 2012
31.
33.
Zurück zum Zitat Dennison E M, Compston J E, Flahive J, Siris E S, Gehlbach S H, Adachi J D, Boonen S, Chapurlat R, Díez-Pérez A, Anderson Jr F A, Hooven F H, Lacroix A Z, Lindsay R, Netelenbos J C, Pfeilschifter J, Rossini M, Roux C, Saag K G, Sambrook P, Silverman S, Watts N B, Greenspan S L , Premaor M, Cooper C (2012) “Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)”. Bone: Mar Dennison E M, Compston J E, Flahive J, Siris E S, Gehlbach S H, Adachi J D, Boonen S, Chapurlat R, Díez-Pérez A, Anderson Jr F A, Hooven F H, Lacroix A Z, Lindsay R, Netelenbos J C, Pfeilschifter J, Rossini M, Roux C, Saag K G, Sambrook P, Silverman S, Watts N B, Greenspan S L , Premaor M, Cooper C (2012) “Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)”. Bone: Mar
34.
Zurück zum Zitat Marzetti E, Leeuwenburgh C (2006) Skeletal muscle apoptosis, sarcopenia and frailty at old age. Exp Gerontol 41(12):1234–1238PubMedCrossRef Marzetti E, Leeuwenburgh C (2006) Skeletal muscle apoptosis, sarcopenia and frailty at old age. Exp Gerontol 41(12):1234–1238PubMedCrossRef
35.
Zurück zum Zitat Woods JL, Iuliano-Burns S, King SJ, Strauss BJ, Walker KZ (2011) Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia. Clin Interv Aging 6:67–76PubMedCentralPubMed Woods JL, Iuliano-Burns S, King SJ, Strauss BJ, Walker KZ (2011) Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia. Clin Interv Aging 6:67–76PubMedCentralPubMed
36.
Zurück zum Zitat Mahalakshmi VN, Ananthakrishnan N, Kate V, Sahai A, Trakroo M (2004) Handgrip strength and endurance as a predictor of postoperative morbidity in surgical patients: can it serve as a simple bedside test? Int Surg 89(2):115–121PubMed Mahalakshmi VN, Ananthakrishnan N, Kate V, Sahai A, Trakroo M (2004) Handgrip strength and endurance as a predictor of postoperative morbidity in surgical patients: can it serve as a simple bedside test? Int Surg 89(2):115–121PubMed
37.
Zurück zum Zitat Sultan P, Hamilton MA, Ackland GL (2012) Preoperative muscle weakness as defined by handgrip strength and postoperative outcomes: a systematic review. BMC Anesthesiol 12:1PubMedCentralPubMedCrossRef Sultan P, Hamilton MA, Ackland GL (2012) Preoperative muscle weakness as defined by handgrip strength and postoperative outcomes: a systematic review. BMC Anesthesiol 12:1PubMedCentralPubMedCrossRef
38.
Zurück zum Zitat Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15(4):377–386PubMedCrossRef Chrischilles E, Shireman T, Wallace R (1994) Costs and health effects of osteoporotic fractures. Bone 15(4):377–386PubMedCrossRef
39.
Zurück zum Zitat Tosteson AN, Rosenthal DI, Melton LJ 3rd, Weinstein MC (1990) Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 113(8):594–603PubMedCrossRef Tosteson AN, Rosenthal DI, Melton LJ 3rd, Weinstein MC (1990) Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 113(8):594–603PubMedCrossRef
40.
Zurück zum Zitat U. S. C. O. of T (1993) Assessment, hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment. The Office U. S. C. O. of T (1993) Assessment, hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment. The Office
41.
Zurück zum Zitat Cummings SR, Rubin SM, Black D (1990) “The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen,”. Clin Orthop Relat Res 252:163–166PubMed Cummings SR, Rubin SM, Black D (1990) “The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen,”. Clin Orthop Relat Res 252:163–166PubMed
Metadaten
Titel
Clinical and economic characteristics of hip fracture patients with and without muscle atrophy/weakness in the United States
verfasst von
Yang Zhao
Shih-Yen Chen
Yuan-Chi Lee
Ning Wu
Publikationsdatum
01.12.2013
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1-2/2013
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-013-0127-2

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