Disclosures: Jonathan P. Etter, MD, PhD: No financial relationships or conflicts of interest
Objective: To determine if non-trauma fracture (NTFx) is a risk factor for incident respiratory disease (RD) in the adult cerebral palsy (CP) population and if NTFx exacerbates RD risk in the adult CP population.
Design: Retrospective cohort study Setting : Nationwide administrative claims data Participants : Adults ≥18 years of age with CP were identified from Optum Clinformatics® Data Mart and Medicare databases by finding ≥1 claim which covered all diagnostic subtypes (e.g., spasticity) between 2012 and 2014. The comparison group included individuals without claims for CP. The sample was then categorized based on the status of CP and NTFx: (1) with CP and NTFx (CP+NTFx) (n=1,384); (2) with CP and without NTFx (CP w/o NTFx) (n=9,710); (3) without CP and with NTFx (w/o CP+NTFx) (n=330,226); and (4) without CP and without NTFx (w/o CP w/o NTFx) (n=5,154,511).
Interventions: Diagnosis codes identified incident RD up to 2 years (pneumonia, chronic obstructive pulmonary disease (COPD), interstitial/pleura disease, other RD), and comorbidities. Crude incidence rates per 100 person years of RD were estimated. Cox regression estimated hazard ratios (HR and 95% confidence interval [CI]) for RD measures, comparing: (1) CP+NTFx; (2) CP w/o NTFx; (3) w/o CP+NTFx; and (4) w/o CP w/o NTFx after adjusting for demographics and comorbidities.
Main Outcome Measures: Incident RD up to 2 years
Results: The crude incidence rate was elevated for CP+NTFx vs. CP w/o NTFx and w/o CP+NTFx for each RD measure. After adjustments, the HR was elevated for CP+NTFx vs. CP w/o NTFx for pneumonia, interstitial/pleura disease, and other RD (all P < 0.05), but not COPD (HR=1.07; 95%CI=0.88-1.31). The adjusted HR was elevated for CP+NTFx vs. w/o CP+NTFx for all RD measures (all P < 0.05). Conclusions: Findings suggest that NTFx is a risk factor for incident RD, including pneumonia, interstitial/pleura disease, and other RD, among adults with CP, and NTFx exacerbates RD risk for adults with vs. without CP.
Level of Evidence: Level II
To cite this abstract in AMA style:
Etter JP, Kannikeswaran S, Hurvitz EA, Caird MS, Jepsen K, Whitney D. The Respiratory Disease Burden of Non-Traumatic Fractures for Adults with Cerebral Palsy [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-respiratory-disease-burden-of-non-traumatic-fractures-for-adults-with-cerebral-palsy/. Accessed May 16, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-respiratory-disease-burden-of-non-traumatic-fractures-for-adults-with-cerebral-palsy/