&lt;p&gt;Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy&lt;/p&gt;

Whitney, Daniel G.; Kamdar, Neil; Ng, Sophia; Hurvitz, Edward A.; Peterson, Mark D.

doi:10.2147/clep.s205839

Cited by 77 publications

(134 citation statements)

References 51 publications

(64 reference statements)

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“…Individuals with CP were identified by at least one claim, which covered all diagnostic subtypes (e.g., spasticity, quadriplegic, and athetoid). Unfortunately, information regarding the severity of CP using common clinical measures (e.g., gross motor function classification system) are not available in claims data, and more than 70% had “other” or “unspecified” CP . This limits the current study as stratification or statistical adjustment for the clinical subtypes of CP is not possible.…”

Section: Methodsmentioning

confidence: 99%

“…Unfortunately, information regarding the severity of CP using common clinical measures (e.g., gross motor function classification system) are not available in claims data, and more than 70% had "other" or "unspecified" CP. 12 This limits the current study as stratification or statistical adjustment for the clinical subtypes of CP is not possible. The comparison group included individuals with no claims for CP.…”

Section: Sample Selectionmentioning

confidence: 99%

“…For individuals with CP, poor musculoskeletal health typically precedes the development of CVD risk factors in children. In adults with CP, the magnitude of the disease disparity compared with adults without CP is far greater for skeletal fragility than CVD . It is possible that skeletal fragility initiates or exacerbates the development of CVD among adults with CP through inadequate mechanical loading, a unique physiological environment (i.e., biological factors released from active and inactive musculoskeletal and adipose tissue), and/or low physical activity.…”

mentioning

confidence: 99%

“…However, this has not been adequately investigated. Understanding if skeletal fragility increases the CVD risk among adults with CP could lead to improved post‐fracture healthcare management and reduced CVD burden . Therefore, the primary objective of this study was to compare CVD incidence in the 12 months following a low‐trauma fracture between adults with versus without CP.…”

mentioning

confidence: 99%

“…Understanding if skeletal fragility increases the CVD risk among adults with CP could lead to improved post-fracture healthcare management and reduced CVD burden. 12,15 Therefore, the primary objective of this study was to compare CVD incidence in the 12 months following a low-trauma fracture between adults with versus without CP. We hypothesized that adults with CP would have a higher post-fracture 12-month CVD incidence compared with adults without CP, even after adjusting for pre-fracture chronic diseases.…”

mentioning

confidence: 99%

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Low‐Trauma Fracture Increases 12‐Month Incidence of Cardiovascular Disease for Adults With Cerebral Palsy

Whitney

Prisby

et al. 2019

Journal Orthopaedic Research

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Individuals with cerebral palsy (CP) have poor skeletal and cardiovascular health. However, no studies have examined if skeletal fragility enhances cardiovascular disease (CVD) risk for this population. The purpose of this study was to determine whether adults with CP have higher 12‐month CVD incidence following a low‐trauma fracture compared with adults without CP. Data, from the Optum Clinformatics® Data Mart, were extracted from adults (18+ years) that sustained a low‐trauma fracture between 01/01/2012 and 12/31/2016. The primary outcome measure was incident CVD within 12 months following a low‐trauma fracture. Cox proportional hazards regression models were used to compare 12‐month incident CVD with adjustment for sociodemographics and chronic disease comorbidities. Mean age (SD) at baseline was 54.7 (18.9) for adults with CP (n = 1,025, 43.3% men) and 60.4 (19.7) for adults without CP (n = 460,504, 33.7% men). During the follow‐up, 121 adults with CP (11.8%, mean age [SD] = 63.9 [16.3]) and 45,330 adults without CP (9.8%, mean age [SD] = 74.5 [11.9]) developed CVD. In the fully adjusted model, adults with CP had higher 12‐month post‐fracture CVD incidence (hazard ratio [HR] = 1.63; 95% confidence interval [CI] = 1.37–1.95). When the outcome was stratified by CVD subtype, adults with CP had higher 12‐month post‐fracture incidence of ischemic heart disease (HR = 1.45; 95% CI = 1.09–1.92), heart failure (HR = 1.68; 95% CI = 1.22–2.31), and cerebrovascular disease (HR = 1.96; 95% CI = 1.54–2.50). Study findings suggest that among adults with CP, low‐trauma fracture may enhance 12‐month CVD incidence compared with adults without CP. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:803‐810, 2020

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Section: Methodsmentioning

confidence: 99%

Section: Sample Selectionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Low‐Trauma Fracture Increases 12‐Month Incidence of Cardiovascular Disease for Adults With Cerebral Palsy

Whitney

Prisby

et al. 2019

Journal Orthopaedic Research

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Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

2019

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Individuals with cerebral palsy (CP) have an increased risk for the early development of osteoporosis; however, little is known about the epidemiology of osteoporosis for adults with CP, which is vital to inform clinical practice for osteoporosis prevention, treatment, and management. The purpose of this cross‐sectional study was to determine sex‐stratified prevalence of osteoporosis among adults with CP, as compared with adults without CP. Data from 2016 were extracted from Optum Clinformatics Data Mart (private insurance administrative claims data) and a random 20% sample from the fee‐for‐service Medicare (public insurance administrative claims data). Diagnostic codes were used to identify CP and osteoporosis diagnoses. Sex‐stratified prevalence of osteoporosis was compared between adults with and without CP for the following age groups: 18 to 30, 31 to 40, 41 to 50, 51 to 60, 61 to 70, and >70 years of age. The overall prevalence of osteoporosis was 4.8% for adults without CP (n = 8.7 million), 8.4% for privately insured adults with CP (n = 7,348), and 14.3% for publicly insured adults with CP (n = 21,907). Women and men with CP had a higher prevalence of osteoporosis compared with women and men without CP for all age groups. Finally, publicly insured women and men with CP had a higher prevalence of osteoporosis compared with privately insured women and men with CP for all age groups, except for the similar prevalence among the 18‐ to 30‐year age group. These findings suggest that osteoporosis is more prevalent among adults with CP compared with adults without CP. Study findings highlight the need for earlier screening and preventive medical services for osteoporosis management among adults with CP. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research

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Chemotherapy‐induced peripheral neuropathy increases nontraumatic fracture risk in breast cancer survivors

et al. 2021

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Chemotherapy is a common treatment for breast cancer (BrCa) and can cause chemotherapy-induced peripheral neuropathy (CIPN). CIPN contributes to falls, and is thus a potential risk factor for nontraumatic fractures (NTFx); yet, the effect of CIPN on NTFx risk has not been examined for BrCa survivors. We therefore investigated the association between CIPN and NTFx in BrCa survivors. Data were extracted from Optum's Deidentified Clinformatics ® Data Mart Database years 2010-2015 in this retrospective cohort study. Among women, three groups were derived based on BrCa and CIPN status: BrCa+/CIPN+ (primary group of interest), BrCa+/CIPNÀ (first comparison group), and BrCaÀ/CIPNÀ (second comparison group). After propensity score matching the comparison groups to BrCa+/CIPN+ at a ratio of 1:11 (BrCa:control) for demographics, osteoporosis, glucocorticoid medication, comorbidities, and cancer-related variables for BrCa+/CIPNÀ, 1-year incidence rate (IR) of NTFx was determined for each group. The incident rate ratio (IRR) determined if the IR for NTFx was different for BrCa+/CIPN+ compared to BrCa+/CIPNÀ and BrCaÀ/CIPNÀ. Cox proportional hazards regression models estimated the hazard ratios (HRs) after adjusting for covariates that were unable to be matched for. The crude IR (95% confidence interval [CI]) of NTFx was 4.54 (2.32-6.77) for BrCa+/CIPN+ (n = 359), 2.53 (2.03-3.04) for BrCa+/CIPNÀ (n = 3949), and 1.76 (1.35-2.18) for BrCaÀ/CIPNÀ (n = 3949). The crude IRR of NTFx was significantly elevated for BrCa+/CIPN+ as compared to BrCa+/CIPNÀ (IRR = 1.80; 95% CI, 1.06-3.05) and BrCaÀ/CIPNÀ (IRR = 2.58; 95% CI, 1.50-4.44). The elevated rate of NTFx for BrCa+/CIPN+ remained unchanged after adjusting for aromatase inhibitors compared to BrCa+/CIPNÀ (HR = 1.79; 95% CI, 1.06-3.04). Female BrCa survivors have an increased 1-year IR of NTFx after the onset of CIPN, suggesting that CIPN is an additive burden on NTFx risk among BrCa survivors.

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<p>Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy</p>

Cited by 77 publications

References 51 publications

Low‐Trauma Fracture Increases 12‐Month Incidence of Cardiovascular Disease for Adults With Cerebral Palsy

Low‐Trauma Fracture Increases 12‐Month Incidence of Cardiovascular Disease for Adults With Cerebral Palsy

Osteoporosis Epidemiology Among Adults With Cerebral Palsy: Findings From Private and Public Administrative Claims Data

Chemotherapy‐induced peripheral neuropathy increases nontraumatic fracture risk in breast cancer survivors

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