Abstract
Summary
Hip fracture incidence rates in Austria over a period of 20 years (1989–2008) were assessed. Age-standardized incidence rates increased until 2005 but decreased thereafter. This change in the secular trend was primarily driven by a decrease in hip fracture incidence in women.
Introduction
The aim of the prevailing study was to assess the incidence rates of hip fractures including changes in trend in the Austrian population over a period of 20 years (1989–2008).
Methods
The number of hip fractures was obtained from the Austrian Hospital Discharge Register for the entire population ≥50 years of age. A correction factor for multiple registrations of the same diagnosis was determined. Incidence rates (cases per 100,000) of hip fracture were calculated in 5-year age intervals. To analyze the overall change in hip fracture for the period, average annual change expressed as incidence rate ratios (IRRs) was calculated.
Results
The age-standardized incidence in women increased until 2005, from 493 to 642, and decreased thereafter. In men, it increased at a measured pace until 2006, from 192 to 280, and decreased thereafter with a slight rebound in 2008. The age-standardized incidence in the entire population increased until 2005, from 376 to 496, and decreased thereafter. The IRR for the last 3 years (2006–2008) was significantly below the IRR for the first 17 years (0.94, ρ < 0.01), driven by a lower IRR in women (0.91, ρ < 0.01) and to a lesser extent by a lower IRR (not statistically significant) in men (0.96, ρ < 0.15).
Conclusion
The present study indicates that since 2006, age-standardized incidence of hip fractures has been declining in the Austrian population aged 50 years and above. This reversal in the secular trend has primarily been driven by a decrease in hip fracture incidence in women.
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References
No authors listed (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med 90(1):107–110
Johnell O (2005) Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7
Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733
Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289
Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Järvinen M (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Res 21(12):1836–1838
Rogmark C, Sernbo I, Johnell O, Nilsson JA (1999) Incidence of hip fractures in Malmö, Sweden, 1992–1995. Acta Orthop Scand 70:19–22
Lofthus CM, Osnes EK, Falch JA, Kaastad TS, Kristiansen IS, Nordsletten L, Stensvold I, Meyer HE (2001) Epidemiology of hip fractures in Oslo, Norway. Bone 29:413–418
Giversen IM (2006) Time trends of age-adjusted incidence rates of first hip fractures: a register-based study among older people in Viborg County, Denmark, 1987–1997. Osteoporos Int 17:552–564
Jaglal SB, Weller I, Mamdani M, Hawker G, Kreder H, Jaakkimainen L, Adachi JD (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905
Melton LJ III, Atkinson EJ, Madhok R (1996) Downturn in hip fracture incidence. Public Health Rep 111:146–150
Hummer C (ed) (2008) Austria. Data. Figures. Facts, 4th edn. Statistics Austria, Federal institution under public law 1110, Vienna, ISBN 978-3-902587-81-7
Mann E, Icks A, Haastert B, Meyer G (2008) Hip fracture incidence in the elderly in Austria: an epidemiological study covering the years 1994 to 2006. BMC Geriatr 23(8):35
Statistics Austria. Federal institution under public law: federal act on federal statistics (Federal Statistics Act 2000) no.163/1999, as amended by BGBL. I, no. 136/2001, by BGBl. I, no.71/2003 and by BGBl. I, no. 92/2007, Vienna
Icks A, Haastert B, Wildner M, Becker C, Meyer G (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19(8):1139–1145
Cooper C (2009) Secular trends in osteoporotic fracture: myth or reality? Osteoporos Int 20(S2):PL4
Chevalley T, Guilley E, Herrmann FR, Hoffmeyer P, Rapin CH, Rizzoli R (2007) Incidence of hip fracture over a 10-year period (1991–2000): reversal of a secular trend. Bone 40(5):1284–1289
Guilley E, Chevalley T, Herrmann F, Baccino D, Hoffmeyer P, Rapin CH, Rizzoli R (2008) Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women. Osteoporos Int 19:1741–1747
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767
Kanis JA, Johnell O, Oden A, Johansson H, De Laet C, Eisman JA, Fujiwara S, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162
Jutberger H, Lorentzon M, Barrett-Connor E, Johansson H, Kanis JA, Ljunggren O, Karlsson M, Rosengren B, Redlund-Johnell I, Orwoll E, Ohlsson C, Mellstrom D (2009) Smoking predicts incident fractures in elderly men: Mr OS Sweden. J Bone Miner Res 9999(999A):1–30
De Laet C, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338
Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD (2006) Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum 35:293–305
Grima DT, Papaioannou A, Thompson MF, Pasquale MK, Adachi JD (2008) Greater first year effectiveness drives favorable cost-effectiveness of brand risedronate versus generic or brand alendronate: modeled Canadian analysis. Osteoporos Int 19:687–697
Abrahamsen B, Vestergaard P (2010) Declining incidence of hip fractures and the extent of use of anti-osteoporotic therapy in Denmark 1997–2006. Osteoporos Int 21:373–380
Nichols HB, Trentham-Dietz A, Hampton JM, Titus-Ernstoff L, Egan KM, Willett WC, Newcomb PA (2006) From menarche to menopause: trends among US women born from 1912 to 1969. Am J Epidemiol 164:1003–1011
Acknowledgments
The study was funded by a medical research fund from the Medical University of Graz. We would like to thank Dr. Erika Baldaszti and Mag. Barbara Leitner from the Statistics Austria for providing us with the data from the Austrian Hospital Discharge Register. We are grateful to Dr. Marlene Klingspiegl, from the Steiermärkische Krankenanstalten Ges.m.b.H., and Ingrid Lackner, from the Hanusch Krankenhaus, Vienna, Fourth Medical Department, for extracting the data file from the hospital register.
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Dimai, H.P., Svedbom, A., Fahrleitner-Pammer, A. et al. Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22, 685–692 (2011). https://doi.org/10.1007/s00198-010-1271-9
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DOI: https://doi.org/10.1007/s00198-010-1271-9