Demographics and medical burden of osteogenesis imperfecta: a nationwide database analysis

Chien-An Shih; Chia-Chun Li; Yin-Fan Chang; Jawl-Shan Hwang; Meng-Che Tsai; Yen-Yin Chou; Chii-Jeng Lin; Ming-Tung Huang; Chih-Kai Hong; Ta-Wei Tai; Chih-Hsing Wu

doi:10.1007/s00198-024-07051-2

Demographics and medical burden of osteogenesis imperfecta: a nationwide database analysis

Osteoporos Int. 2024 Apr 2. doi: 10.1007/s00198-024-07051-2. Online ahead of print.

Authors

Chien-An Shih^#^{1

2

3}, Chia-Chun Li^#^{4

5}, Yin-Fan Chang^{5

6

7}, Jawl-Shan Hwang⁸, Meng-Che Tsai⁹, Yen-Yin Chou⁹, Chii-Jeng Lin^{1

2

3

10}, Ming-Tung Huang¹, Chih-Kai Hong¹, Ta-Wei Tai^{11

12}, Chih-Hsing Wu^{13

14

15}

Affiliations

¹ Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan.
³ Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
⁹ Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹⁰ Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, Taiwan.
¹¹ Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. david0803@gmail.com.
¹² Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan. david0803@gmail.com.
¹³ Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
¹⁴ Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
¹⁵ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.

^# Contributed equally.

PMID: 38563961
DOI: 10.1007/s00198-024-07051-2

Abstract

The epidemiological data on osteogenesis imperfecta (OI) in Asia is limited. This study, representing the first comprehensive epidemiological investigation on OI in Taiwan, reveals high medical resource utilization and underscores the importance of early diagnosis to enhance care quality.

Introduction: This study examines osteogenesis imperfecta, a hereditary connective tissue disorder causing pediatric fractures and limb deformities, using a nationwide database from Taiwan to analyze clinical features and medical burden.

Methods: The study identified validated OI patients from the Catastrophic Illness Registry in the National Health Insurance Research Database from 2008 to 2019. Demographic data and medical resource utilization were analyzed. A multivariate Cox model assessed the influence of sex, validation age, and comorbidities.

Results: 319 OI patients (M/F = 153/166) were identified, with 58% validated before age 20. Prevalence and incidence were 0.8-1.3/100,000 and 0.02-0.09/100,000, respectively, with higher rates in the pediatric demographic. In the study period, 69.6% of the patients had admission history, primarily to pediatric and orthopedic wards. The median admission number was 3, with a median length of stay of 12 days and a median inpatient cost of approximately 3,163 USD during the period. Lower limb fractures were the main reason for hospitalization. 57% of OI patients received bisphosphonate treatment. The leading causes of mortality were OI-related deaths, neurovascular disease, and cardiovascular disease. The median age of validation in the non-survival group was significantly higher compared to the survival group (33 vs. 14 years), and patients validated during childhood required more inpatient fracture surgeries than those validated during adulthood.

Conclusion: This study provides comprehensive real-world evidence on the clinical characteristics and high medical resource utilization of OI patients in a low prevalence region like Taiwan. Early diagnosis is crucial for improving care quality and enhancing health outcomes.

Keywords: Epidemiology; Fracture; Mortality; Osteogenesis imperfecta; Real-world evidence.

Abstract

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