title: 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.
authors.affiliation: Eli Lilly and Company , Indianapolis, IN , USA.
authors.forename: Zhanglin
authors.initials: Z
authors.lastname: Cui
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schoenfeld
authors.forename: Elizabeth Nicole
authors.initials: EN
authors.lastname: Bush
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Russel
authors.initials: R
authors.lastname: Burge
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006304:Health Status; D006620:Hip Fractures / Q000191:economics*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000191:economics*; D009133:Muscular Atrophy / Q000191:economics*; D012737:Sex Factors
keywords: CART analysis; Health outcomes; Healthcare cost; Healthcare utilization; Hip fracture; Muscle atrophy/weakness