Table 3.

Predictors of Time to First Fracture

Characteristic	Adjusted Hazard Ratio	95% CI	P
Cystectomy
No	Reference		< .001
Yes	1.21	1.10 to 1.32
Age at diagnosis, years
66-69	Reference		< .001
70-74	1.22	1.13 to 1.31
75-79	1.49	1.39 to 1.60
≥ 80	2.17	2.02 to 2.32
Sex
Male	Reference		< .001
Female	1.61	1.54 to 1.68
Race
White	Reference		< .001
Black	0.48	0.42 to 0.55
Hispanic	0.78	0.64 to 0.95
Other	0.85	0.75 to 0.95
Census tract median income
1st quartile	Reference		NS
2nd quartile	0.99	0.93 to 1.05
3rd quartile	1.00	0.94 to 1.06
4th quartile	1.04	0.98 to 1.10
Unknown	1.07	0.99 to 1.17
Urban-rural residence
Nonmetropolitan	Reference		NS
Metropolitan	1.06	0.99 to 1.12
Region
Midwest	Reference		< .001
South	1.13	1.05 to 1.21
Northeast	0.99	0.93 to 1.06
West	1.06	1.00 to 1.12
Married
Yes	Reference		< .001
No	1.13	1.08 to 1.18
Unknown	0.98	0.90 to 1.06
Grade
1	Reference		NS
2	0.98	0.92 to 1.03
3	1.02	0.95 to 1.08
4	1.00	0.94 to 1.08
Unknown	1.03	0.95 to 1.12
AJCC stage
0	Reference		< .001
I	1.05	0.99 to 1.11
II	1.22	1.12 to 1.33
III	1.29	1.15 to 1.46
Lymph node involvement
Negative	Reference		< .001
Unknown/not evaluated	1.38	1.23 to 1.54
Chemotherapy
None	Reference		< .001
Systemic ± intravesical	0.56	0.53 to 0.60
Intravesical only	0.49	0.43 to 0.55
Charlson comorbidity score
0	Reference		< .001
1	1.23	1.18 to 1.29
≥ 2	1.55	1.47 to 1.63
History of chronic kidney disease
No	Reference		< .001
Yes	1.16	1.06 to 1.26
History of fracture
No	Reference		< .001
Yes	2.97	2.80 to 3.15
Year of diagnosis	1.00	0.98 to 1.01	NS

NOTE. History of chronic kidney disease on the basis of diagnosis codes from inpatient and outpatient claims in the year prior to bladder cancer diagnosis. History of fracture on the basis of diagnosis codes from inpatient and outpatient claims in the year prior to bladder cancer diagnosis or cystectomy.

Abbreviations: AJCC, American Joint Committee on Cancer; NS, not significant.