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Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study.

ABSTRACT: Bone fractures may have an impact on prognosis of breast cancer. The long-term risks of bone fracture in breast cancer patients have not been thoroughly studied.Poisson regression was used to investigate the incidence of hospitalisation due to bone fracture comparing women with and without breast cancer based on Swedish National registers. Cox regression was used to investigate the risk of being hospitalised with bone fracture, and subsequent risk of death, in a regional cohort of breast cancer patients.For breast cancer patients, the 5-year risk of bone fracture hospitalisation was 4.8% and the 30-day risk of death following a bone fracture hospitalisation was 2.0%. Compared with the general population, breast cancer patients had incidence rate ratios of 1.25 (95% CI: 1.23-1.28) and 1.18 (95% CI: 1.14-1.22) for hospitalisation due to any bone fracture and hip fracture, respectively. These ratios remained significantly increased for 10 years. Comorbidities (Charlson Comorbidity Index ?1) were associated with the risk of being hospitalised with bone fracture. Women taking aromatase inhibitors were at an increased risk as compared with women taking tamoxifen (HR=1.48; 95% CI: 0.98-2.22). Breast cancer patients hospitalised for a bone fracture showed a higher risk of death (HR=1.83; 95% CI: 1.50-2.22) compared with those without bone fracture.Women with a previous breast cancer diagnosis are at an increased risk of hospitalisation due to a bone fracture, particularly if they have other comorbidities.

SUBMITTER: Colzani E

PROVIDER: S-EPMC5129831 | biostudies-other | 2016 Nov

REPOSITORIES: biostudies-other

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Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study.

Colzani Edoardo E Clements Mark M Johansson Anna L V AL Liljegren Annelie A He Wei W Brand Judith J Adolfsson Jan J Fornander Tommy T Hall Per P Czene Kamila K

British journal of cancer 20161004 11

<h4>Background</h4>Bone fractures may have an impact on prognosis of breast cancer. The long-term risks of bone fracture in breast cancer patients have not been thoroughly studied.<h4>Methods</h4>Poisson regression was used to investigate the incidence of hospitalisation due to bone fracture comparing women with and without breast cancer based on Swedish National registers. Cox regression was used to investigate the risk of being hospitalised with bone fracture, and subsequent risk of death, in ...[more]

PMID: 27701383

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Project description:ObjectivesDevelop predictive models using an administrative healthcare database that provide information for Patient-Centred Medical Homes to proactively identify patients at risk of hospitalisation for conditions that may be impacted through improved patient care.DesignRetrospective healthcare utilisation analysis with multivariate logistic regression models.DataA population-based longitudinal database of residents served by the Emilia-Romagna, Italy, health service in the years 2004-2012 including demographic information and utilisation of health services by 3,726,380 people aged ≥18 years.Outcome measuresModels designed to predict risk of hospitalisation or death in 2012 for problems that are potentially avoidable were developed and evaluated using the area under the receiver operating curve C-statistic, in terms of their sensitivity, specificity and positive predictive value, and for calibration to assess performance across levels of predicted risk.ResultsAmong the 3,726,380 adult residents of Emilia-Romagna at the end of 2011, 449,163 (12.1%) were hospitalised in 2012; 4.2% were hospitalised for the selected conditions or died in 2012 (3.6% hospitalised, 1.3% died). The C-statistic for predicting 2012 outcomes was 0.856. The model was well calibrated across categories of predicted risk. For those patients in the highest predicted risk decile group, the average predicted risk was 23.9% and the actual prevalence of hospitalisation or death was 24.2%.ConclusionsWe have developed a population-based model using a longitudinal administrative database that identifies the risk of hospitalisation for residents of the Emilia-Romagna region with a level of performance as high as, or higher than, similar models. The results of this model, along with profiles of patients identified as high risk are being provided to the physicians and other healthcare professionals associated with the Patient Centred Medical Homes to aid in planning for care management and interventions that may reduce their patients' likelihood of a preventable, high-cost hospitalisation.

Dataset Information

Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study.

Publications

Risk of hospitalisation and death due to bone fractures after breast cancer: a registry-based cohort study.

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