Is There an Increased Risk of Hip Fracture in Multiple Sclerosis (MS)? Analysis of the Nationwide Inpatient Sample (NIS) (P06.201)

Abstract

Objective: To determine if people with MS have a higher rate of hip fractures and to explore the discharge disposition of MS patients with acute hip fracture. Background Impaired ambulation, frequent falls, and prolonged immobilization combined with the high rate of vitamin D deficiency in people with MS could lead to an increased risk of hip fracture. Design/Methods: Retrospective cohort analysis of 20 years of the NIS (HCUP, AGRQ.gov), a 20% stratified sample of US hospital admissions. Admissions with a primary diagnosis of acute hip fracture were identified, as was the subset with a secondary diagnosis of MS. Indirect adjustment was used to compare the prevalence of MS in this population, to that of the US (Noonan, Neurology, 2002). Because of the large number of records and multiple comparisons, p was set a priori at Results: 0.25% of 1,063,726 hip fracture admissions were for MS. Over the 20 years of this dataset the proportion with MS increased from 0.21% to 0.31%. There was a trend for lesser mortality for MS (0.25 vs. 2.97%, p Conclusions: In this nationwide sample of 20 years of US hospital admissions the rate of hip fracture for people with MS was more than twice predicted. While the risk of falls can be partially mitigated through physical therapy and fractures with vitamin D, bisphosphonates are less effective in pre-menopausal women. Disclosure: Dr. Dubinsky has received personal compensation for activities with Allergan Pharmaceuticals as a speaker.Dr. Dubinsky has received research support from Allergan Pharmaceuticals, Medevation Pharmaceuticals, and NIH. Dr. Bhattacharya has nothing to disclose.