Cataract surgery lowers chance of hip fracture

Patients who underwent cataract surgery had lower odds of hip fracture within 1 year after surgery compared with patients who did not undergo cataract surgery, according to a study published recently in the Journal of the American Medical Association.

Researchers used the Denominator and Physician/Supplier Part B files and randomly pulled 5% of Medicare Part B beneficiaries with cataract who either had cataract surgery or did not have cataract surgery from 2002 to 2009. During the study period, 36.9% of patients received cataract surgery. Patients who did receive surgery were followed up for 1 year after the date of surgery, which was defined by the date of the first service bill for cataract surgery, whereas patients who did not receive surgery were followed up for the calendar year in which the diagnosis appeared. Researchers adjusted analyses for age, sex, race/ethnicity/ US region of residence, systemic comorbidities, cataract severity and presence of physically limiting conditions.

The primary outcome measure was the occurrence of hip fracture during the follow-up period and the secondary outcome was the occurrence of any fracture during the follow-up period.

Study results showed 1.3% of patients sustained a hip fracture during the study period and that osteoporosis was the most common fracture-related comorbidity (12.1%). Within 1 year, patients in the upper five deciles of propensity scores had lower odds of hip fractures. The odds of hip fractures within 1 year in the cataract surgery group progressively decreased with each increasing decile of propensity score compared with the cataract diagnosis group, according to study results. Patients aged 75 years and older who underwent cataract surgery had a lower likelihood of fractures within 1 year and patients 80 to 84 years old had the lowest odds of hip fracture vs. patients of the same age in the cataract diagnosis group.

 “Cataract surgery has already been demonstrated to be a cost-effective intervention for visual improvement, with an estimated cost per quality-adjusted life-year gained for cataract surgery in the first eye of $2,023 in the United States and $2,727 in the second eye,” the researchers concluded. “The results in this study suggest the need for further investigation of the additional potential benefit of cataract surgery as a cost-effective intervention to decrease the incidence of fractures in the elderly.”

For more information:

Tseng VL, Yu F, Lum F, et al. Risk of fractures following cataract surgery in Medicare beneficiaries. JAMA. 2012;308:493-501.

Disclosures: The researchers had no relevant financial disclosures.

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