Hospitalizations for fracture in patients with metastatic disease: primary source lesions in the United States

Abstract

I t has been well established that metastatic disease to bone has major signi cance in the morbidity associated with the diagnosis of cancer. 1 More than 75% of patients with metastatic cancer will have bone involvement at the time of death. 2-4 Moreover, there is a reported 8% incidence of a pathologic fracture in patients who carry the diagnosis of cancer. 5 Common sites of involvement include the spine, ribs, pelvis, and long bones such as humerus and femur. 6 Pathologic fracture is fracture caused by disease rather than injury or trauma (referred to here as nonpathologic). In any bone, pathologic fracture will be associated with increased morbidity for the patient, but it is the spine and long bones that frequently require surgical intervention and are associated with high mortality and morbidity. Advanced cancer can also increase fracture risk through increasing falls; in one prospective study of patients with advanced cancer, more than half the patients experienced a fall. 7 Based on historical studies of patients who have died from common cancers, 4,6 it is commonly

A Tailored Approach for Appendicular Impending and Pathologic Fractures in Solid Cancer Metastases

“…In 2018, Nikkel et al reported 17,313 hospitalizations due to pathologic fractures and 12,770 due to non-pathologic fractures (related to metastases, secondary to minor trauma) in patients with metastatic bone disease between 2003 and 2010 in the US. In this report, kidney cancer had the highest hospitalization rate for pathologic fractures [ 17 ]. In 2011, Jensen et al reported a 45% rate of SREs, including pathologic fractures, among patients with BM in Denmark [ 18 ].…”