Are annual fluctuations in hip fracture incidence dependent upon the underlying mortality rate?

There is substantial variation in hip fracture incidence rates from one year to the next. To determine whether this is related to varying mortality rates in the underlying population, we carried out an ecological analysis in Rochester and Olmsted County, Minnesota. In a given year, mortality in the general population was not related to hip fracture incidence nor did the fracture incidence rates influence the overall death rate. There was a negative correlation between hip fracture incidence and mortality in the preceding year among women, but not men; the trend was statistically significant among women less than 80 years of age. Both cervical and intertrochanteric hip fractures in women had a similar relationship to mortality in the population the year before. There was no consistent relationship between hip fracture incidence and mortality rates two or three years previously. Although many hip fractures occur in frail individuals near the end of life, patterns of mortality in the underlying population cannot account for the annual variation in hip fracture incidence.     

2002-2006年天津市甲状腺癌发病率与26年间长期趋势分析

目的 对2002-2006年期间天津城市居民的甲状腺癌发病率进行描述性流行病学研究,合并天津市26年的发病率数据进行长期趋势分析,并与历史同期上海市和美国发病率数据进行比较.方法 计算甲状腺癌发病率的年度百分比变化以及全癌谱的发病率顺位,分析不同组织类型的发病率时间趋势以及占全部新发病例的构成比变化.结果 2006年女...     

Increasing hip fracture incidence in California Hispanics, 1983 to 2000

Background: Hip fracture incidence in non-Hispanic whites (NHW) has decreased nationwide for the past 20 years. Little is known regarding hip fracture incidence among Hispanics, the largest, fastest growing minority in the United States. Objective: To assess the change in standardized hip fracture incidence from 1983 through 2000 in California Hispanics relative to other racial groups. Design: Hospitalizations for individuals older than 55 years with hip fracture requiring repair in acute care hospitals. Annual population estimates based on US Census Bureau estimates. Incidence standardized to national gender-age strata. Change in annual incidence calculated by weighted linear regression with robust variance estimates. Results: 372,078 hip fractures were identified. Age-adjusted annual incidence of hip fractures declined by 0.74% per year among women (655 to 568 per 100,000), but was unchanged among men (247 to 238 per 100,000). Among NHW women, the standardized annual incidence fell by 0.6% (4.0 fractures per 100,000) per year. Annual incidence among Hispanic women increased 4.9% (11.1 fractures per 100,000) per year. Annual incidence among Hispanic men increased by 4.2% (4.5 fractures per 100,000) per year and among NHW men by 0.5% (1.2 fractures per 100,000) per year. No significant change occurred among black or Asian women or men. Conclusions: Among California women, hip fracture incidence has doubled among Hispanics since 1983, while remaining unchanged or declining in other groups. Greater attention should be given to identification of individuals at risk for hip fracture and initiation of preventive measures in Hispanic populations.     

Secular trends in hip fracture incidence and recurrence

Summary  The decline in hip fracture incidence is now accompanied by a further reduction in the likelihood of a recurrent hip fracture among survivors of the first fracture. Introduction  Hip fracture incidence is declining in North America, but trends in hip fracture recurrence have not been described. Methods  All hip fracture events among Olmsted County, Minnesota residents in 1980–2006 were identified. Secular trends were assessed using Poisson regression, and predictors of recurrence were evaluated with Andersen–Gill time-to-fracture regression models. Results  Altogether, 2,752 hip fractures (median age, 83 years; 76% female) were observed, including 311 recurrences. Between 1980 and 2006, the incidence of a first-ever hip fracture declined by 1.37%/year for women (p < 0.001) and 0.06%/year for men (p = 0.917). Among 2,434 residents with a first-ever hip fracture, the cumulative incidence of a second hip fracture after 10 years was 11% in women and 6% in men with death treated as a competing risk. Age and calendar year of fracture were independently associated with hip fracture recurrence. Accounting for the reduction in first-ever hip fracture rates over time, hip fracture recurrence appeared to decline after 1997. Conclusion  A recent reduction in hip fracture recurrence is somewhat greater than expected from the declining incidence of hip fractures generally. Additional research is needed to determine the extent to which this can be attributed to improved patient management.     

Trend in hip fracture epidemiology over a 14-year period in a Spanish population

Spain lacks detailed data on hip fracture trends despite being the country with the greatest increase in the pensioner-to-provider ratio in Europe. We reproduced a study on hip fracture incidence in a region of northern Spain (Cantabria) carried out 14 years ago to determine whether a secular trend to change is taking place. If such a trend could be found, our objective was to determine whether the effect is solely due to ageing or whether additional variables are involved. We assessed the incidence of hip fracture in patients aged ≥50 years through clinical records from Emergency Units and Orthopedic Surgical Units of all hospitals in the region of Cantabria in 1988 and 2002. A total of 318 new cases of hip fracture were recorded in 1988 and 490 in 2002 (54% increase; p<0.001). No significant changes were noticed following an adjustment for age. Women accounted for the increase in crude hip fracture incidence [246 women and 72 men suffered a hip fracture in 1988 compared to 404 women and 86 men in 2002 (64% increase in women and 19% increase in men; p<0.005 and not significant, respectively)]. The female:male ratio was 3.4 in 1988 versus 4.7 in 2002; following age-adjustment, no significant changes were found (1.8 in 1988 and 1.9 in 2002). The increase in crude hip fracture incidence was greater at cervical (versus trochanteric) sites. Patient residence, time of the year, site of fracture, kind of injury, previous contralateral hip fracture, length of stay, and peri-operative mortality did not differ significantly. In conclusion, a crude hip fracture incidence increase of about 50% in the northern Spanish region of Cantabria has taken place over the last 14 years. This effect does not persist after adjustments have been made for age. The crude rate increase occurred mainly at the expense of women, with a more noticeable rise in cervical fractures as opposed to trochanteric lesions.     

Recent trends in the incidence and lifetime risk of hip fracture in Tottori, Japan

Summary  Hip fracture incidence from 2004 to 2006 in the Tottori prefecture of Japan was investigated and compared with previously reported rates. The age- and gender-specific incidence of hip fracture in the Tottori prefecture has not plateaued, as has been reported for populations in Northern Europe or North America. Introduction  Recent data from Northern Europe and North America indicate that the incidence of hip fracture has plateaued, whereas most reports from Asia indicate that the incidence is increasing. The aims of this study were to investigate the recent incidence of hip fracture in the Tottori prefecture, Japan, and to compare it with previous reports. Methods  All hip fractures in patients aged 35 years and older occurring between 2004 and 2006 were surveyed in all of the hospitals from the Tottori prefecture. The age- and gender-specific incidence rates were then calculated. Using these and previously reported data, the estimated number of hip fracture patients was determined using the age- and gender-specific incidence rates in each year from 1986 to 2006. Results  The survey identified 851, 906, and 1,059 patients aged 35 years and older, in 2004, 2005, and 2006 respectively. The residual lifetime risk of hip fracture for individuals at 50 years of age was estimated to be 5.6% for men and 20.0% for women. The estimated number of patients from 1986 to 2006 showed a significant increase over time for both genders. Conclusions  The age- and gender-specific incidence of hip fracture in the Tottori prefecture, Japan has not plateaued for either gender.     

Trend of hip fracture incidence in Germany 1995–2004: a population-based study

We analyzed hip fracture incidence trends in Germany 1995-2004, using national hospital discharge register. Crude incidences per 100,000 increased from 121.2 (95% CI 120.5-121.9) in 1995 to 140.9 (140.2-141.7) in 2004. Age-sex-adjusted annual incidence ratios showed a statistically significant, but only slight increase (1.01, p < 0.01), compared to higher rises in the past. Trends differed markedly with sex, age, and regions. INTRODUCTION: Data concerning actual trends of the hip fracture incidence and differences for sex, age, and region are limited. We analyzed hip fracture incidence trends in Germany 1995-2004, using the national hospital discharge register. Crude incidences per 100,000 increased from 121.2 (95% CI 120.5-121.9) in 1995 to 140.9 (140.2-141.7) in 2004. Age-sex-adjusted annual incidence ratios showed a statistically significant, but only slight increase (1.01, p < 0.01), compared to higher rises in the past. Trends differed markedly with sex, age, and regions. METHODS: Analysis of annual hip fracture incidences using the national hospital discharge register. Estimate of age-sex-adjusted changes was found by using Poisson regression (incidence rate ratios, IRR). RESULTS: The number of patients with at least one hospital admission for hip fracture increased (1995: n = 99,141; 2004: n = 116,281). Crude incidences per 100,000 were 121.2 (95% confidence interval 120.5-121,9) and 140.9 (140.2-141.7), respectively. The age-sex-adjusted hip fracture incidence increased statistically significantly, but only slightly (IRR per year: 1.01; 1.00-1.01; IRR 1995-2004: 1.05, p < 0.01). In men aged 40 years or older, incidences increased. In women, there was a tendency of a decrease up to 74 years of age, but also a significant increase in higher age groups. In people 0-39 years, the incidence declined markedly (IRR 1995-2004, men 0.74; 0.69-0.79, women 0.62; 0.55-0.69, both p < 0.01). The increase was significantly higher in Eastern compared to Western Germany (interaction: p = 0.002), and differences between East and West decreased. CONCLUSIONS: In contrast to earlier years, the hip fracture incidence in Germany 1995-2004 increased only slightly, with a decline in younger people, but increases in older ages, particularly in men. Regional differences decreased.     

A healthy decline in age- and sex- specific incidence of hip fractures in the elderly in the Republic of Ireland

AimThe number of patients sustaining hip fractures in the Republic of Ireland was expected to increase by 100% from 2004 to 2026. This has not been seen either in local or international literature. Our aim is to assess the age- and sex-specific incidence of hip fractures in patients over the age of 65 years and to determine whether the projected increase in incidence is mirrored in the reality of the Irish experience.MethodsThis is a retrospective observational cohort study including all patients with a hip fracture from a tertiary referral centre from 2005 to 2015. Population data was obtained from the Central Statistics Office of Ireland.Results3818 hip fractures in the over 65 age group were recorded. The highest incidence of hip fractures occurred in the 85–90 year old age group. For all ages over 65, the incidence of hip fractures in females over the 10 year period is significantly reducing (p < 0.01). There were 955 hip fractures per 100,000 in females in 2010 and 410 per 100,000 in males. In 2014, this had reduced to 668 in females and 332 in males respectively.ConclusionThe annual hip fracture incidence has decreased across both sexes in this study period. This may be associated with preventative measures and introduction of fracture liaison services. This study highlights the importance of investment in preventative strategies for a continued reduction in hip fracture incidence and will help to plan future services.     

The apparent incidence of hip fracture in Europe: A study of national register sources

The objective of this study was to examine the apparent incidence of hip fracture from discharge rates in European countries. A request was sent to the Ministries of Health in all European countries, asking for the number of hip fracture patients by age and sex, between the years 1983 and 1985. Seventeen countries responded. As expected, hip fracture was most frequently found amongst the elderly, particularly women. The incidence of hip fracture rose exponentially with age in both sexes. It was higher in women than men and there was a three-fold range between countries in the female to male sex ratio. There was an eleven-fold range in apparent incidence amongst women and a seven-fold range amongst men between the various countries. The highest incidence was found in the northern part of Europe and the lowest in the Mediterranean area. There was a significant positive correlation between the age-standardized incidence rates reported in men from each country and that in women. There was a larger difference in incidence between countries than between sexes, which suggests important genetic or environmental factors in the causation of hip fracture. The extent to which this reflects imperfect capture of data is uncertain but will be important to determine in order to identify reasons for differences and to enable confident projections of the future magnitude of this disorder.The MEDOS Study Group comprises:Collaborating centres G. Dilzen (Istanbul), C. Gennari (Sienna), A. A. Lopez-Vaz (Porto), G. Lyritis (Athens), G. F. Mazzuoli (Rome), L. Miravet (Paris), M. Passeri (Parma), R. Perez-Cano (Seville), A. Rapado (Madrid), C. Ribot (Toulouse).Project group E. Allander (WHO Epidemiology, Huddinge), J. Dequeker (WHO Osteoporosis, Leuven), J. A. Kanis (European Foundation for Osteoporosis and Bone Disease, Sheffield), D. Loew (Sandoz, Basle), N. Khaltaev (WHO Non-communicable diseases, Geneva), M. Pluss (Sandoz, Basle).     

High incidence rate of hip fracture in Taiwan: estimated from a nationwide health insurance database

The objective of this study was to describe the incidence rate of hip fracture from 1996 to 2000 in Taiwan, based on an inpatient database of the National Health Insurance Program. A total of 54,199 patients, who had a first-time admission for a diagnosis of hip fracture (ICD9 code 820.0 through 820.9, 820.21, 820.22, and 820.31) on discharge from January 1996 through December 2000 and aged 50 to 100 years, were identified and included in the study. The results showed that the age-specific incidence rates of hip fractures were higher with increasing age in both genders, in an exponential manner after 65 years of age. The incidence was 1.6 times higher and rose about 5 years earlier among women than among men. Thus in these 5 years the age-adjusted incidence rates (95% confidence interval) of hip fracture in Taiwan were 225 (95% CI, 188–263) per 100,000 in men and 505 (95% CI, 423–585) per 100,000 in women (adjusted to US white population of 1989), as compared with US white rate of 187 in men and 535 in women. More than half of the fractures were peritrochanteric, and the recorded cause in most cases was a fall on the same level, from slipping, tripping, or stumbling (ICD9 E885). A total of 37.8% patients had hip hemiarthroplasty, 51.2% had open reduction of fracture with internal fixation, and 10.5% had closed reduction of fracture with internal fixation. We concluded that, using the data from a nationwide health insurance database of Taiwan, we found a high annual incidence rate of hip fracture for both men and women in 5 consecutive years. These incidence rates were higher than other reports on Chinese populations reported in the past 10 years and similar to that of Western countries. With the rapid aging of the populations of Taiwan and other Asian countries in the years to come, our results clearly demonstrated the impact of osteoporosis and hip fracture in this region.     

老年髋部骨折患者骨密度阈值的初步探讨

作者收集３９例６０岁以上髋部骨折病人作为病例组，其中男１７例，女２２例。另选８０例６０岁以上正常老年人作为对照组。其中男女各４０例。采用双能量骨密度仪分别测定其脊柱及髋部各部位的骨密度值。测量结果表明无论是脊柱还是髋部，骨折组骨密度均显著低于对照组（Ｐ＜０．０１）。其中髋部Ｗａｒｄ’ｓ三角区骨密度下降最为明显。骨折组Ｗａｒｄ’ｓ三角区ＢＭＤ值平均为０．４８８８±０．１１０８。作者提出对高危人群进行普查，如发现髋部Ｗａｒｄ’ｓ三角区ＢＭＤ值低于０．５ｇ／ｃｍ２时，对其采取治疗及保护措施是十分必要的。     

Increasing incidence of hip fracture in Tottori Prefecture, Japan: Trend from 1986 to 2001

We conducted a survey of all hip fractures in patients 35 years old and over during 1998–2001 in Tottori Prefecture, Japan, and compared them with those reported previously. The survey found 604, 671, 710, 729 patients, in 1998, 1999, 2000, and 2001, respectively. The mean age- and gender-specific incidences (per 100,000 person-years) for men were 108.0, 209.0, 449.1, and 780.0 in the age groups of 70–74, 75–79, 80–84 and over 84, respectively, and those for women were 249.1, 505.8, 1,115.4, and 2,066.4, respectively. The expected numbers of patients in 1998 were 1.23 and 1.42 times those in 1986, and those in 2001 were 1.61 and 1.48 times those in 1986, for men and women, respectively, and the increases with time for both genders were significant. It was concluded that there was a significant increase in the incidence rates of hip fracture from 1986 to 2001.     

Time trends of age-adjusted incidence rates of first hip fractures: a register-based study among older people in Viborg County, Denmark, 1987–1997

Introduction A retrospective cohort study was performed to investigate if incidence rates of first hip fractures are changing in a Danish county. Study material was obtained from an excerpt from a computerized national health register and covers the period 1987–1997. Methods First hip fractures were identified through a search 10 years back from the date of admission. To assess the 20-year trend, 1978 data were included. The study period saw inclusion of 3,036 first (1987–1997) and 122 first and recurrent (1978) hip fracture patients aged 50 years and older. Data were analyzed using weighted regression analysis. Results Age-adjusted first hip fracture incidence rates increased significantly (P<0.001) for women, men, and pertrochanteric fractures. The rate of increase was 18 [95% confidence interval (CI), 12–25], 8 (95% CI, 4–12), and 10 (95% CI, 7–12) per 100,000 per year for women, men, and pertrochanteric fractures, respectively. The age-adjusted rate for both genders combined was 425 per 100,000 in 1997 (95% CI, 380–470). The incidence of cervical fractures was stable. If the rates of 1978 were included in the analysis, the cervical hip fractures also increased (P<0.001). The weighted average of female–male ratio was a stable 2.6 (95% CI, 2.4–2.8). Cervical–pertrochanteric ratio dropped to 1.2:1 (P<0.001). Mean age at admission rose from 78.9 to 80.8 years. Conclusion In conclusion, the results provided support for an increasing incidence of first hip fractures, even when aging of the population was accounted for.     

老年髋部骨折患者术后对侧髋部骨折发生因素的Meta分析

目的通过Meta分析评价影响老年髋部骨折患者术后对侧髋部骨折的相关因素。方法检索Pubmed、Cochrane、中国生物医学文献数据库、CNKI中国期刊全文数据库、万方数据库自2005年1月至2018年4月国内外正式刊物上公开发表的有关老年髋部骨折术后对侧髋部骨折相关因素的文献,严格评价质量及提取相关资料,获取患者的性别、年龄(>65岁)、吸烟、初次髋部骨折类型、骨质疏松症(Singh指数≥4为骨质疏松)、伴有原发性高血压、伴有帕金森病、伴有脑卒中、伴有老年痴呆症、伴有白内障、伴有类风湿关节炎、伴有糖尿病、初次骨折内固定种类、患者治疗配合的依从性。运用RevMan5.0软件进行统计分析,评估各项指标的优势比(OR)和95%可信区间(CI)。结果共纳入17项研究13717例老年髋部骨折患者,发生对侧髋部骨折1504例。影响老年髋部骨折术后对侧髋部骨折的相关因素有患者年龄(OR=-3.55,95%CI:-5.60^-1.50,P<0.001)、骨质疏松症(OR=2.38,95%CI:1.36~4.17,P=0.002)、伴有帕金森病(OR=4.54,95%CI:2.74~7.53,P<0.001)、脑卒中(OR=0.33,95%CI:0.18~0.59,P<0.001)、老年痴呆症(OR=0.43,95%CI:0.29~0.62,P<0.001)、白内障(OR=0.37,95%CI:0.22~0.63,P<0.001)、类风湿关节炎(OR=0.32,95%CI:0.21~0.50,P<0.001)、糖尿病(OR=0.65,95%CI:0.47~0.91,P=0.01)、初次骨折内固定种类(OR=0.51,95%CI:0.30~0.85,P=0.01)、治疗配合依从性(OR=0.36,95%CI:0.21~0.64,P<0.001),而与性别(OR=1.07,95%CI:0.45~2.56,P=0.88)、吸烟(OR=0.86,95%CI:0.40~1.86,P=0.70)、初次髋部骨折类型(OR=0.97,95%CI:0.60~1.57,P=0.90)、伴有原发性高血压(OR=0.70,95%CI:0.41~1.21,P=0.20)无关。结论影响老年髋部骨折患者术后对侧髋部骨折的相关因素有年龄偏大、伴有骨质疏松症、帕金森病、脑卒中、老年痴呆症、白内障、类风湿关节炎、糖尿病、初次骨折内固定种类、治疗配合依从性差。而患者性别、吸烟、骨折类型、伴有原发性高血压目前尚无足够的证据与对侧髋部骨折有关。     

Change in the use of hormone replacement therapy and the incidence of fracture in Oslo

Summary  Fracture incidence in Oslo decreased from the 1970s to the 1990s in younger postmenopausal women, but not in older women or in men. Concurrently, hormone replacement therapy increased considerably. Using data from the Oslo Health Study, we estimated that roughly half the decline might be attributed hormone replacement therapy. Introduction  Between the late 1970s and the late 1990s, the incidence of hip fracture and distal forearm fracture decreased in younger postmenopausal women in Oslo, but not in elderly women or in men. The purpose of this report is to evaluate whether the decreased incidence was coherent with trends in use of hormone replacement therapy (HRT). Methods  Data on estrogens were collected from official drug statistics, data on fractures from published studies and data on bone mineral density (BMD) from the Oslo Health Study. Results  The sale of all estrogens increased 22 times from 1979 to 1999, and the sub-category estradiol combined with progestin increased 35 times. In the corresponding period the incidence of distal forearm fracture in women aged 50–64 years decreased by 33% and hip fracture by 39%. Based on differences in BMD between users and non-users of HRT, we estimated that up to half of this decline might be due to HRT. Conclusions  The reduction in fracture incidence in postmenopausal women in Oslo occurred in a period with a substantial increase in the use of HRT. Future surveillance will reveal whether the last years’ decline in use of HRT will be translated into increasing fracture rates.     

Impairment of bone turnover in elderly women with hip fracture

Summary Hip fracture is one of the most severe consequences of osteoporosis affecting aged women. However, abnormalities of bone turnover responsible for bone loss in this condition have not been clearly defined. To further evaluate the bone metabolic status of women sustaining hip fracture, we have prospectively measured serum osteocalcin as a marker of bone formation and urinary excretion of pyridinoline (Pyr) and deoxypyridinoline (D-pyr) cross-links as markers of bone collagen degradation in 174 independently living women (80 ± 8 years) within a few hours after a hip fracture. Comparison was made with 77 age-matched controls (80 ± 5 years) and 17 premenopausal women (39 ± 3 years). In addition 15 of the patients were followed with daily measurements during the first postoperative week. At the time of admission osteocalcin was 20% lower in the fractured women compared to the elderly controls (7.6 ± 3.8 vs. 9.5 ± 4.5 nglml,P = 0.001). Pyr and D-pyr were 36% and 40% higher, respectively (P = 0.0001), than in elderly controls and 85% and 76% higher than in premenopausal controls (P = 0.0001). Serum osteocalcin did not correlate with the cortisol level measured at the same time (r = 0.03, ns), nor with serum albumin and creatinine. Serum osteocalcin remained unchanged within 18 hours after fracture, whereafter it progressively decreased until the third postoperative day. No correlation was noted between the excretion of pyridinoline cross-links and the time elapsed from fracture.These data suggest that the abnormal levels of osteocalcin and pyridinolines are unrelated to traumatically induced acute changes, but reflect abnormalities of bone turnover existing prior to the fracture. Thus, hip-fracture patients have biochemical evidence of decreased bone formation and increased bone resorption when compared to age-matched controls. We suggest that these abnormalities may play a role in the decrease of the bone mass and the consequently increased bone fragility that characterize the osteoporotic hip fracture in the elderly.     

Hip fracture incidence in Japan

The purpose of this study was to determine incidence and regional distribution of hip fracture throughout Japan. The incidence rate of hip fracture in Japan was estimated by a nationwide survey for departments of orthopedics of all hospitals with 200 beds or more and supplementary survey for all medical institutions in three prefectures. The mail survey was used in main and supplementary survey. The mail questionnaire included items such as the number of new patients seen during 1 January through 31 December 1987 regardeless of cause of fracture, and also sex, age and address of each patients.     

中国沈阳髋部骨折的流行病学研究

本研究的目的是调查分析沈阳人群（１９９４年人口为３１９５０４６）髋部骨折的发病率及其流行病学特点。研究材料是从沈阳市３５个医院的病案室或住院部收集的髋部骨折（股骨颈骨折和股骨粗隆部骨折）病例记录。结果显示：１９９４年沈阳市５０岁以上人口发生髋部骨折４５３例，男性为２４７例，女性为２０６例。总发病率为７４．０／１０００００，男性为８０．８／１０００００，女性为６７．２／１０００００（Ｐ＞０．０５）。男性发病率在６０岁以上明显增加，然而，这种现象在女性不明显。总髋部骨折发病率的男／女比为１．２。髋部骨折患者的平均年龄为６７．２±９．５（男性为６７．５±９．８，女性为６６．９±９．０）。骨折类型有性别差异（Ｐ＜０．００１），股骨颈骨折／粗隆骨折比，女性为３．２，男性为１．６。季节影响髋部骨折的发生（Ｐ＜０．０００１），冬季和夏季髋部骨折发生人数较多，夏季意外事故引起的骨折明显增加，冬季摔倒引起的骨折较多。     

Incidence of hip fractures in the city of Rosario, Argentina

In order to determine the incidence of hip fractures (HFx) in the city of Rosario, Argentina, (population, about 900,000), all HFx admitted to 26 medical centers from August 2001 to July 2002 were surveyed. Exclusion criteria were pathological fractures, violent trauma, and fractures in patients living outside urban limits. Demographical data were obtained from the 2001 national census, and the 1991 national census with projections made by the citys statistics department. In the study period, there were 763 HFx in persons aged 50 or older (608 in women and 155 in men). The annual incidence among inhabitants over the age of 50 years was 290 per 100,000 (405 for women, and 137 for men; female/male ratio: 2.96). In the population aged 65 or older, the global incidence was 646 per 100,000 (847 for women, and 343 for men; ratio: 2.47). The mean age (±SD) of fractured patients was 79.5±9.2 years; median age was 81 years (range: 50–104). Fractured men were younger (76.2±9.8 years vs 80.7±8.3 years; p <0.0001) and leaner (body mass index [BMI], 24.5±3.0 kg/m² vs 26.0±2.8 kg/m²; p <0.0001) than fractured women. Most fractured patients either had normal BMI (35%) or were overweight (BMI, 25.1–30.0 kg/m²; 47.5%). The incidence of fractures increased exponentially with advancing age. Relative risks of HFx (females/males) were calculated for each decade of life; the risk in individuals below the age of 69 was the same in both sexes; in those aged 70 or more the risk was significantly higher among women. Parental origin of fractured patients was mainly Spanish or Italian, reflecting the citys ethnic composition. Most fractures (72.5%) occurred in houses; 20% in apartments, and 7.5% in nursing homes. HFx were trochanteric in 54.4% of cases. Female patients with trochanteric fractures were older than those with cervical ones (80.0±9.4 years vs 78.2±11.4 years; p <0.01); their weights and BMIs did not differ significantly. The majority of HFx were treated surgically (91.8%); in-hospital mortality was 1.4%. In conclusion, incidence rates of HFx were somewhat higher in Rosario than those found in two other cities of central Argentina one decade earlier.     

The incidence and risk of hip fracture in Poland

Summary  This study determined the incidence and probability of hip fractures in Poland based on verified hospital discharge notes from all of Poland. In the over-50-year-old population, hip fracture incidence was found to be 89/100,000 for men and 156/100,000 for women. Poland is among the countries with the lowest hip fracture risk in Europe. Introduction  It is recommended that intervention thresholds should be based on an assessment of absolute fracture risk. Probability of hip fracture is calculated from the incidence of hip fracture in a given population and the incidence of death. The aim of this study was to determine the incidence and the absolute risk of hip fracture for men and women in Poland. Methods  The study was based on National Health Fund data from all of Poland for the year 2005. Hospital discharge notes reporting an incident fracture were identified from among all those containing a matching ICD code. Lifetime and 10-year fracture probabilities were calculated taking into account the mortality risk and BMD. Results  In 2005, there were 17,625 hip fractures diagnosed in Poland which was 30.2% less than the number of hospital discharge notes containing such a diagnosis in that year. In the over-50-year-old population, hip fracture incidence was found to be 89/100,000 for men and 165/100,000 for women. In the 50–65-year band, hip fracture incidence was higher in men than in women. The remaining lifetime probability of hip fracture at the age of 50 years was 2.0% for men and 4.5% for women which are among the lowest in Europe. Conclusion  Hip fracture incidence and thus the probability of hip fracture risk in Poland is amongst the lowest in Europe. The authors recommend establishing a standard method for determining hip fracture incidence in a given country in order to standardize data. Funding  None of the authors has received or will receive any compensation in relation to this study.