Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study
Introduction There are limited data on the management of bone health, including bone mineral density (BMD) evaluation and osteoporosis (OP) treatment, in patients undergoing elective orthopaedic surgeries. Methods This was a retrospective cohort study using administrative claims data from Symphony H...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-11-01
|
| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593231216553 |
| _version_ | 1797384958304583680 |
|---|---|
| author | Kyle J. Jeray MD Setareh A. Williams PhD Yamei Wang PhD Leny Pearman PhD Nick Pyrih BS Karun Singla MD Benjamin H. Han MD Susan V. Bukata MD |
| author_facet | Kyle J. Jeray MD Setareh A. Williams PhD Yamei Wang PhD Leny Pearman PhD Nick Pyrih BS Karun Singla MD Benjamin H. Han MD Susan V. Bukata MD |
| author_sort | Kyle J. Jeray MD |
| collection | DOAJ |
| description | Introduction There are limited data on the management of bone health, including bone mineral density (BMD) evaluation and osteoporosis (OP) treatment, in patients undergoing elective orthopaedic surgeries. Methods This was a retrospective cohort study using administrative claims data from Symphony Health, PatientSource for patients aged ≥50 years with documented kyphoplasty/vertebroplasty (KP/VP), total knee arthroplasty (TKA), and total hip arthroplasty (THA). Risk stratification to identify patients at very high risk for fracture (VHRFx) was based on clinical practice guideline recommendations to the extent information on variables of interest were available from the claims database. Results A total of 251 919 patients met inclusion criteria: KP/VP (31 018), TKA (149 849), and THA (71 052). The majority were female (80.3%) with a mean (SD) age of 68.5 (7.5) years. Patients undergoing KP/VP were older and had a greater comorbidity burden associated with risk for falls, mobility issues, muscle weakness, and respiratory and cardiovascular diseases. In the 6 months before surgery, 11.8% of patients were tested and/or received treatment for OP. Patients undergoing KP/VP were more likely to be tested and/or treated (17.5%) than patients undergoing TKA (11.0%) or THA (10.9%). Overall, men had a lower rate of testing and/or treatment than women (4.6% vs 13.5%). In the 12 months before surgery, patients with an OP diagnosis and at VHRFx (30.8%) had a higher rate of treatment and/or testing than those without OP (11.5%), or those without OP but with a fracture in the year preceding surgery (10.2%). Conclusions Bone health management is suboptimal in patients undergoing elective orthopaedic surgeries and is worse in men than in women. Proper management of OP before and after surgery may improve outcomes. |
| first_indexed | 2024-03-08T21:47:13Z |
| format | Article |
| id | doaj.art-7b475a7a1b9b4a7fabd9b8b641fcfc9b |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-03-08T21:47:13Z |
| publishDate | 2023-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-7b475a7a1b9b4a7fabd9b8b641fcfc9b2023-12-20T08:03:20ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932023-11-011410.1177/21514593231216553Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational StudyKyle J. Jeray MDSetareh A. Williams PhDYamei Wang PhDLeny Pearman PhDNick Pyrih BSKarun Singla MDBenjamin H. Han MDSusan V. Bukata MDIntroduction There are limited data on the management of bone health, including bone mineral density (BMD) evaluation and osteoporosis (OP) treatment, in patients undergoing elective orthopaedic surgeries. Methods This was a retrospective cohort study using administrative claims data from Symphony Health, PatientSource for patients aged ≥50 years with documented kyphoplasty/vertebroplasty (KP/VP), total knee arthroplasty (TKA), and total hip arthroplasty (THA). Risk stratification to identify patients at very high risk for fracture (VHRFx) was based on clinical practice guideline recommendations to the extent information on variables of interest were available from the claims database. Results A total of 251 919 patients met inclusion criteria: KP/VP (31 018), TKA (149 849), and THA (71 052). The majority were female (80.3%) with a mean (SD) age of 68.5 (7.5) years. Patients undergoing KP/VP were older and had a greater comorbidity burden associated with risk for falls, mobility issues, muscle weakness, and respiratory and cardiovascular diseases. In the 6 months before surgery, 11.8% of patients were tested and/or received treatment for OP. Patients undergoing KP/VP were more likely to be tested and/or treated (17.5%) than patients undergoing TKA (11.0%) or THA (10.9%). Overall, men had a lower rate of testing and/or treatment than women (4.6% vs 13.5%). In the 12 months before surgery, patients with an OP diagnosis and at VHRFx (30.8%) had a higher rate of treatment and/or testing than those without OP (11.5%), or those without OP but with a fracture in the year preceding surgery (10.2%). Conclusions Bone health management is suboptimal in patients undergoing elective orthopaedic surgeries and is worse in men than in women. Proper management of OP before and after surgery may improve outcomes.https://doi.org/10.1177/21514593231216553 |
| spellingShingle | Kyle J. Jeray MD Setareh A. Williams PhD Yamei Wang PhD Leny Pearman PhD Nick Pyrih BS Karun Singla MD Benjamin H. Han MD Susan V. Bukata MD Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study |
| title_full | Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study |
| title_fullStr | Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study |
| title_full_unstemmed | Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study |
| title_short | Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study |
| title_sort | bone health management in elective orthopaedic surgery a claims based observational study |
| url | https://doi.org/10.1177/21514593231216553 |
| work_keys_str_mv | AT kylejjeraymd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT setarehawilliamsphd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT yameiwangphd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT lenypearmanphd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT nickpyrihbs bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT karunsinglamd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT benjaminhhanmd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy AT susanvbukatamd bonehealthmanagementinelectiveorthopaedicsurgeryaclaimsbasedobservationalstudy |