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An updated hip fracture incidence rate for Brazil: the Brazilian Validation Osteoporosis Study (BRAVOS)

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Abstract

Summary

Hip fracture incidence rates in three representative geographic areas in Brazil over a period of 2 years (2010–2012) were assessed for the first time. Estimated incidence rates varied regionally, and markedly differed from those previously reported. Thus, national guidelines as well as FRAX Brazil should be revised in light of this new data.

Purpose

To determine the annual incidence of hip fractures in individuals aged 50 years and over, living in 3 cities located in different regions of the country. To investigate the age, gender, and regional differences in fracture rates. Based on the obtained data, to estimate the national incidence of hip fractures resulting from osteoporosis, in order to improve prevention strategies.

Methods

Retrospective, observational study including all patients aged ≥ 50 years admitted in hospitals because of a hip fracture in three cities (Belem, Joinville, and Vitoria) from representative geographic areas in Brazil from 2010 to 2012. Data were obtained from medical records in those cities. We analyzed incidence rates (crude and age- and gender-standardized rates) for hip fractures.

Results

There were 1025 (310 in men and 715 in women) hip fractures in the over 50-year-old merged population from the three cities. The crude incidence rate for hip fracture was 103.3/100,000 (95% confidence interval [CI = 97.0; 109.7), in men 77.4/100,000 (95% CI = 68.8; 86.0), and in women 125.2/100,000 (95% CI = 116.0; 134.4). Incidence standardized for age and gender was 105.9 cases per 100,000 persons per year (95% CI = 99.4; 112.4); 78.5 cases per 100,000 (95% CI = 69.8; 87.3) in men and 130.6 cases 100,000 in women (95% CI = 121.0, 140.2) per year. Belem, located in the equatorial region (latitude 1° 27′ S), had significantly lower crude and age-adjusted incidence than Joinville (latitude 26° 18′ S) and Vitoria (latitude 20° 19′ S), which were no different from each other. The incidence of fractures increased exponentially with age, and women had about twice the risk of fractures than men.

Conclusions

Hip fracture mainly affects elderly women and presents great variability in incidence between the different regions in Brazil. The incidence of hip fractures in Brazil differed markedly from that reported previously, so that national guidelines and the FRAX model for Brazil should be revised.

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Funding

This study was supported by unrestricted research grants from the Servier do Brasil Ltda.

Author information

Authors and Affiliations

  1. Osteoporosis Research and Diagnosis Center - CEDOES, Vitoria, Brazil

    Ben-Hur Albergaria & Sergio Ragi Eis

  2. Federal University of Espirito Santo, Vitoria, Brazil

    Ben-Hur Albergaria

  3. Centro Paulista de Investigação Clinica, Sao Paulo, Brazil

    Cristiano A. F. Zerbini

  4. Federal University of São Paulo, Sao Paulo, Brazil

    Vera Lucia Szejnfeld & Marise Lazaretti-Castro

  5. Medical School of Univille, Joinville, Brazil

    Dalisbor Marcelo Weber Silva

  6. Federal University of Para, Belem, Brazil

    Maria de Fatima Lobato da Cunha

  7. Oregon Osteoporosis Center, Portland, OR, USA

    Michael R. McClung

  8. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK

    John A. Kanis & Eugene V. McCloskey

  9. Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia

    John A. Kanis

  10. Mellanby Centre for Bone Research, MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK

    Eugene V. McCloskey

  11. Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

    Tatiane Vilaca

Authors
  1. Ben-Hur Albergaria
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  2. Cristiano A. F. Zerbini
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  3. Vera Lucia Szejnfeld
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  4. Sergio Ragi Eis
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  5. Dalisbor Marcelo Weber Silva
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  6. Maria de Fatima Lobato da Cunha
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  7. Michael R. McClung
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  8. John A. Kanis
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  9. Eugene V. McCloskey
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  10. Tatiane Vilaca
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  11. Marise Lazaretti-Castro
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Corresponding author

Correspondence to Ben-Hur Albergaria.

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The ethics committees of the institutions where the research took place approved the study.

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The authors declare no competing interests.

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Sergio Ragi Eis is deceased. This paper is dedicated to his memory.

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Albergaria, BH., Zerbini, C.A.F., Szejnfeld, V.L. et al. An updated hip fracture incidence rate for Brazil: the Brazilian Validation Osteoporosis Study (BRAVOS). Arch Osteoporos 17, 90 (2022). https://doi.org/10.1007/s11657-022-01127-4

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