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Clinical features and burden of osteoporotic fractures among the elderly in the USA from 2016 to 2018

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Abstract

Summary

This study provides a national estimate of the incidence of hospitalizations and assesses the clinical features and outcomes during inpatient admission due to osteoporotic fractures diagnosed by ICD-10-CM/PCS among the elderly in the USA, using the US Nationwide Inpatient Sample, 2016–2018.

Purpose

To provide a national estimate of the incidence of hospitalizations and assess the clinical features and outcomes during inpatient admission due to osteoporotic fractures (OFs) among the elderly in the USA.

Methods

The study included all inpatients aged 65 years and older who participated in the US Nationwide Inpatient Sample (NIS). We conducted a retrospective analysis of hospitalizations with OFs diagnosed by the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS), using the US NIS, 2016–2018. Trends in epidemiological characteristics and outcomes were calculated by annual percentage change (APC).

Results

From 2016 to 2018, there were an estimated 0.16 million hospitalizations for OFs, and the estimated annual incidence rate changed from 995 cases per 1 million persons in 2016 to 1114 cases per 1 million persons in 2018 (APC, 5.8% [95% CI, 0.0 to 12.0]; P > 0.05). Over two-thirds of the patients (68.2%) were age-related osteoporosis with current pathological fracture, and OFs were more likely to occur in vertebra (51.7%) and femur (34.7%). During the hospitalization, the average length of stay (LOS) was 5.83 days, the average cost reached $60,901.04, and the overall mortality was 2.3%. All outcomes including LOS, average cost and mortality did not change significantly in 2016–2018 (all P values for trend were over 0.05).

Conclusion

Between 2016 and 2018, the incidence rate of OFs remained relatively stable, but the total number of cases was huge. OFs was predominantly age-related, mostly in vertebrae and femurs, with relatively stable cost and mortality during hospitalization.

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Funding

This study was funded by the Clinical Research Center of Shandong University (Nos. 2021SDUCRCC002, 2020SDUCRCA008), Taishan Scholars Program of Shandong Province-Young Taishan Scholars (No. tsqn201909197), and the National Natural Science Foundation of China (Nos. 81972073 and 81930070).

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Author notes

  1. Yongfu Lou, Wei Wang and Chaoyu Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, International Science and Technology Cooperation Base of Spinal Cord Injury, Tianjin Key Laboratory of Spine and Spinal Cord, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of China

    Yongfu Lou, Wei Wang, Chaoyu Wang, Shenghui Shang, Yi Kang, Huan Jian, Yigang Lv, Mengfan Hou, Hengxing Zhou & Shiqing Feng

  2. Department of Orthopaedics, Qilu Hospital, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, People’s Republic of China

    Yongfu Lou, Wei Wang, Chaoyu Wang, Runhan Fu, Shenghui Shang, Chi Zhang, Lingxiao Chen, Hengxing Zhou & Shiqing Feng

  3. Faculty of Medicine and Health, The Back Pain Research Team, Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia

    Lingxiao Chen

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  1. Yongfu Lou
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Corresponding authors

Correspondence to Lingxiao Chen, Hengxing Zhou or Shiqing Feng.

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Yongfu Lou, Wei Wang, Chaoyu Wang, Runhan Fu, Shenghui Shang, Yi Kang, Chi Zhang, Huan Jian, Yigang Lv, Mengfan Hou, Lingxiao Chen, Hengxing Zhou, and Shiqing Feng declare that they have no conflict of interest.

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Lou, Y., Wang, W., Wang, C. et al. Clinical features and burden of osteoporotic fractures among the elderly in the USA from 2016 to 2018. Arch Osteoporos 17, 78 (2022). https://doi.org/10.1007/s11657-022-01113-w

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