Table 4.

Predictors of Cost following Periprosthetic Hip Fracture

Predictor	Change in cost (%)	95% CI	P-value
Race
Asian or Pacific Islander	23.3	12.6-34.1	<0.001
Hispanic	9.9	4.8-15.0	<0.001
Black	7.9	2.8-13.0	<0.001
Comorbidities
Metastatic cancer	24.6	15.4-33.9	<0.001
Paralysis	24.5	11.1-37.8	<0.001
Fluid and electrolyte disorders	20.0	17.7-22.2	<0.001
Coagulopathy	17.0	13.0-20.9	<0.001
Weight loss	14.2	10.2-18.2	<0.001
Liver disease	13.8	7.9-19.7	<0.001
Deficiency anemia	11.4	7.2-15.7	<0.001
Other neurological disorders	10.9	7.9-13.9	<0.001
Pulmonary circulation disorders	10.4	5.2-15.6	<0.001
Cardiac arrhythmias	9.8	7.6-12.0	<0.001
Drug abuse	6.7	0.4-13.0	0.004
Obesity	6.5	3.5-9.4	<0.001
Congestive heart failure	6.2	2.5-9.8	<0.001
Peripheral vascular disorders	5.7	1.9-9.5	<0.001
Diabetes, complicated	5.5	2.1-8.9	<0.001
Diabetes, uncomplicated	5.4	2.1-8.7	<0.001
Valvular disease	5.0	1.4-8.6	0.001
Chronic pulmonary disease	5.0	2.6-7.3	<0.001
Renal failure	4.2	0.3-8.1	0.004
Hospital type
Urban teaching	–12.7	–16.8 to –8.5	<0.001
Procedure
ORIF and revision	40.6	37.8-43.4	<0.001
Revision	35.0	32.2-37.7	<0.001
Nonoperative	–74.6	–77.2 to –72.0	<0.001

Data derived from the NIS (National Inpatient Sample).

Change in cost is represented in dollars.

All adult patients diagnosed with a hip periprosthetic fracture between 2016 and 2019 were included.

Linear regression was used with hospital cost as the outcome variable. The cost was log-transformed prior to analysis and reversed for interpretation. Only statistically significant variables (P<0.05) are shown in the table. In addition to significant predictors, the final model included admission day, hospital size and comorbidities, including AIDS, alcohol use disorder, blood loss anemia, depression, hypertension, lymphoma, peptic ulcer disease, and psychoses.

Reference variables were White race, Medicare as a primary payment source, absence of comorbidity, ORIF and rural hospital.

ORIF: open reduction and internal fixation, CI: confidence interval.