Characteristics of hip fracture patients with and without muscle atrophy/weakness: Predictors of negative economic outcomes

Abstract

Objective:

Hip fractures have negative humanistic and economic consequences. Predictors and sub-groups of negative post-fracture outcomes (high costs and extensive healthcare utilization) were identified in patients with and without muscle atrophy/weakness (MAW).

Methods:

Truven Health MarketScan data identified patients ≥50 years old with inpatient hospitalizations for hip fracture. Patients had ≥12 months of continuous healthcare insurance prior to and following index hospitalization and no hip fracture diagnoses between 7 days and 1 year prior to admission. Predictors and sub-groups of negative outcomes were identified via multiple logistic regression analyses and classification and regression tree (CART) analyses, respectively.

Results:

Post-fracture 1-year all-cause healthcare costs (USD$31,430) were higher than costs for the prior year ($18,091; p < 0.0001). Patients with MAW had greater post-fracture healthcare utilization and costs than those without MAW (p < 0.05). Greater post-fracture costs were associated with a higher number of prior hospitalizations and emergency room visits, length of index hospitalization, Charlson Comorbidity Index (CCI), and discharge status; diagnosis of rheumatoid arthritis, osteoarthritis, or osteoporosis; and prior use of antidepressants, anticonvulsants, muscle relaxants, benzodiazepines, opioids, and oral corticosteroids (all p < 0.009). High-cost patient sub-groups included those with MAW and high CCI scores.

Conclusions:

Negative post-fracture outcomes were associated with MAW vs no MAW, prior hospitalizations, comorbidities, and medications.

Keywords::

• Healthcare cost
• Hip fracture
• Health outcomes
• Muscle atrophy/weakness
• Healthcare utilization
• CART analysis

Transparency

Declaration of personal interests

ZC, RB, MS, & EB are all employees and stockholders of Eli Lilly and Company. YC was an employee of InVentiv Health clinical at the time of the study.

Declaration of funding interests

This study and the preparation of this paper were funded in full by Eli Lilly and Company. Data analyses were performed, in part, by InVentiv Health clinical, Indianapolis, IN. Writing support was provided by Teresa Tartaglione, PharmD of ClinGenuity, LLC, Cincinnati, OH. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank Teresa Tartaglione, PharmD (ClinGenuity, LLC, Cincinnati, OH) for medical writing support and assistance with preparation and submission of this paper.