Pathologic fractures after metastatic disease linked with higher costs, longer stays

LAS VEGAS — Patients with pathological fractures related to metastatic lung, breast, prostate, kidney and colorectal carcinoma have a greater risk of additional hospitalizations and health care costs compared to patients with non-pathological fractures or hospitalization unrelated to fractures, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Lucas Nikkel, MD, and his colleagues hypothesized that pathologic fractures related to common metastatic cancers would result in more hospitalizations than less common cancers. His team studied the National Inpatient Sample, which is a public database that represents about 20% of U.S. patients. The team used ICD-9 codes to identify more than 20,000 adult patients with pathological fractures, more than 11,000 patients with non-pathological fractures and more than 900,000 hospitalized patients without fractures.

Patients with pathological fractures were more likely to visit teaching hospitals, have longer duration of hospitalization and spent $20,000 more on health care costs on average than patients with non-pathological fractures or patients without fractures. The proportion of admissions of patients with pathological fractures was highest among patients with multiple myeloma, according to Nikkel.

During his presentation, Nikkel said limitations of the study include its retrospective nature, and that the data may include coding errors and does not include outpatient visits for fractures. However, he noted that the evidence strongly suggests that pathological fractures are associated with higher health care costs and treatment duration. – by Shirley Pulawski

Reference:

Nikkel L, et al. Paper #150. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.

Disclosure: Nikkel reports no relevant financial disclosures.