PMD145 - CHARACTERIZING BURDEN OF INTRAOPERATIVE AND EARLY POSTOPERATIVE PERIPROSTHETIC HIP FRACTURES FOLLOWING TOTAL HIP ARTHROPLASTY

Abstract

To characterize the burden imposed by intraoperative and early postoperative (≤90 days) periprosthetic hip fractures (PPHFx) in terms of medical resource utilization and costs. This retrospective observational cohort study used health care claims from the United States Centers for Medicare and Medicaid Standard Analytic File (100%) sample. Patients aged 65+ with intraoperative or postoperative PPHFx (index) between 2010 and 2016 were identified. Patients had concurrent diagnosis for hip osteoarthritis and procedural code for THA with concurrent PPHFx (intraoperative cohort) or PPHFx identified between day 1 to 90 post-discharge. The proportion of patients admitted at least once to a skilled nursing facility (SNF), an inpatient rehabilitation facility (IRF), another inpatient site or an outpatient hospital during from 0-90 or 0-365 days post-PPHFx, and the total all-cause payments during those periods were analyzed. The results were separately reported for patients with intraoperative vs postoperative PPHFx. A total of 2,976 patients with intraoperative PPHFx (average age (standard deviation SD): 76.3 (6.7) - 75.9% female) and 1,473 patients with postoperative PPHFx (average age (SD): 75.1(6.5) – 77.3% female), were identified. For intraoperative PPHFx, during 90- and 365-day post-index PPHFx, 44.2% and 44.8% patients were admitted to SNF, 18.4% and 19.5% to IRF, 18.6% and 34.8% to other inpatient admission and, 73.1% and 91.6% to outpatient hospital respectively. For postoperative PPHFx, during 90-day and one-year post-index PPHFx, 57.8% and 59.8% patients were admitted to SNF, 15.8% and 17.3% to IRF, 27.2% and 41.3% to other inpatient admission and, 72.5% and 92.0% to outpatient hospital respectively. The mean(SD) total all-cause payments at 0-90 and 0-365-days post-PPHFX averaged $31,533($21,626) and $39,645($31,925) for intraoperative PPHFx and $37,459($22,633) and $47,199($32,621) for postoperative PPHFx. This real-world study found increased healthcare burden on patients who had a total hip arthroplasty followed by an intraoperative or postoperative PPHFx.