Falls and Fractures in Patients with Geographic Atrophy: A US Claims Data Analysis

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-03-13 DOI:10.1007/s12325-025-03134-6

Allen Hu, Rachel E. Teneralli, Rachelle Rodriguez, Alyshah Abdul Sultan, Colleen Garey, Jessica Ackert, Rose Ong

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引用次数: 0

Abstract

Introduction

The increased risk of falls in elderly people represents a substantial public health burden that may be compounded by impaired visual acuity. The present study aimed to assess the independent risk of incident falls and fractures in patients with geographic atrophy (GA).

Methods

This retrospective, noninterventional, cohort study analyzed three US claims datasets (Optum’s de-identified Clinformatics^® Data Mart Database [Clinformatics^®], Merative™ MarketScan^® Commercial and Medicare Databases [MarketScan], and IQVIA US PharMetrics^® [PharMetrics]). Patients were defined as having at least one International Classification of Diseases, Tenth Revision code (H35.31x3, H35.31x4) for GA. A propensity score-matched control cohort, matched on age, sex, index year, and disease history, was also included. Relative risks (RRs) for incident falls, fractures, and health care resource utilization (HCRU) were calculated between GA and control cohorts.

Results

The Clinformatics^®, MarketScan, and PharMetrics datasets included 44,591, 9470, and 27,428 patients with GA, respectively. Across the three databases, mean (SD) age ranged from 75.9 (8.3) to 80.5 (7.2) years, and 61% to 64% were female. The largest subgroup was patients with bilateral GA without subfoveal involvement (35–37%), followed by unilateral GA without subfoveal involvement (23–24%). Risks of falls (RR 1.16–1.36) and fractures (RR 1.17–1.29) in the 4 years following the index date were higher in patients with GA compared with controls. Patients with bilateral GA and subfoveal involvement had the most pronounced increase in risk of falls (RR 1.42–1.49) and fractures (RR 1.33–1.45). Compared to controls, patients with GA also had an increased risk for hospitalization (RR 1.18–1.27), emergency department visits (RR 1.18–1.21), nursing home or assisted living admissions (RR 1.06–1.28), and outpatient visits (RR 1.05–1.08).

Conclusion

GA represents an independent risk factor for falls, fractures, and higher HCRU. These data reveal the substantial public health burden of GA associated with the management of falls and fractures.

查看原文本刊更多论文

地理萎缩患者的跌倒和骨折：美国索赔数据分析。

老年人跌倒风险的增加是一项重大的公共卫生负担，可能因视力受损而加重。本研究旨在评估地理萎缩（GA）患者意外跌倒和骨折的独立风险。方法：这项回顾性、非干预性、队列研究分析了三个美国索赔数据集（Optum的去识别Clinformatics®数据集市数据库[Clinformatics®]、Merative™MarketScan®商业和医疗保险数据库[MarketScan]和IQVIA US PharMetrics®[PharMetrics]）。患者被定义为至少具有一种GA的国际疾病分类第十版代码（H35.31x3, H35.31x4）。在年龄、性别、指标年份和疾病史上，还纳入了倾向评分匹配的对照队列。计算GA组和对照组之间发生意外跌倒、骨折和卫生保健资源利用（HCRU）的相对风险（rr）。结果：Clinformatics®、MarketScan和PharMetrics数据集分别包括44,591、9470和27,428例GA患者。在三个数据库中，平均（SD）年龄范围为75.9（8.3）至80.5（7.2）岁，61%至64%为女性。最大的亚组是不累及中央凹下的双侧GA(35-37%)，其次是不累及中央凹下的单侧GA（23-24%）。与对照组相比，GA患者在指数日期后的4年内跌倒（RR 1.16-1.36）和骨折（RR 1.17-1.29）的风险更高。双侧GA和中央凹下受累的患者发生跌倒（RR 1.42-1.49）和骨折（RR 1.33-1.45）的风险增加最为明显。与对照组相比，GA患者住院（RR 1.18-1.27）、急诊科就诊（RR 1.18-1.21）、养老院或辅助生活住院（RR 1.06-1.28）和门诊就诊（RR 1.05-1.08）的风险也增加。结论：GA是跌倒、骨折和高HCRU的独立危险因素。这些数据揭示了与跌倒和骨折管理相关的GA的巨大公共卫生负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.