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

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.