Osteoporosis International

, Volume 16, Issue 11, pp 1339–1344 | Cite as

Incidence of hip fractures in the city of Rosario, Argentina

Original Article

Abstract

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 city’s 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 city’s 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.

Keywords

Argentina Epidemiology Hip fracture Incidence 

Notes

Acknowledgements

This survey was made possible by a grant from ELEA S.A. (Buenos Aires). The authors wish to express their thanks to all participating physicians and surgeons, and to the research assistants E. Badino, F. Bentancur, I. Lisa, and M.F. Tomat

References

  1. 1.
    Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289Google Scholar
  2. 2.
    Norris RJ (1992) Medical costs of osteoporosis. Bone 13 [Suppl 2]:S11–16Google Scholar
  3. 3.
    Elffors I, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Vaz AAL, Lyritis G, Mazzuoli GF, Miravet L, Passeri M, Cano RP, Rapado A, Ribot C (1994) The variable incidence of hip fracture in southern Europe: The MEDOS Study. Osteoporos Int 4:253–263Google Scholar
  4. 4.
    Kaastad TS, Meyer HE, Falch JA (1998) Incidence of hip fracture in Oslo, Norway: Differences within the city. Bone 22:175–178Google Scholar
  5. 5.
    Bagur A, Rubin Z, García G, Mautalen CA (1991) Epidemiología de las fracturas de fémur proximal en La Plata, Argentina. Medicina (B Aires) 51:343–347Google Scholar
  6. 6.
    Bagur A, Mautalen C, Rubin Z (1994) Epidemiology of hip fractures in an urban population of central Argentina. Osteoporos Int 4:332–335Google Scholar
  7. 7.
    Mosquera MT, Maurel DL, Pavón S, Arregui A, Moreno C, Vázquez J (1998) Incidencia y factores de riesgo de la fractura de fémur proximal por osteoporosis. Panam J Public Health 3:211–218Google Scholar
  8. 8.
    Brasca AP, Pezzotto SM, Berli D, Villavicencio R, Fay O, Gianguzzo MP, Poletto L (2000) Epidemiology of gallstone disease in Argentina: Prevalences in the general population and European descendants. Dig Dis Sci 45:2392–2398Google Scholar
  9. 9.
    Sánchez A, Puche R, Zeni S, Oliveri B, Galich AM, Maffei L, Plantalech L, Poudes G, Bregni C (2002) Papel del calcio y la vitamina D en la salud ósea. Rev Esp Enf Metab Oseas 11:201–17 (Part 1). (2003);12:14–29 (Part 2)Google Scholar
  10. 10.
    Oliveri B, Plantalech L, Bagur A, Wittich AC, Rovai G, Pusiol E, López Giovanelli J, Ponce G, Nieva A, Chaperón A, Ladizesky M, Somoza J, Casco C, Zeni S, Parisi M, Mautalen CA (2004) High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina. Eur J Clin Nutr 58:337–342Google Scholar
  11. 11.
    Sánchez A, Carretto H, Parma R, Capozza R, Zanchetta JR (1992) Densitometría ósea en mujeres de Rosario y su zona. Rev Med Rosario 60:25–31Google Scholar
  12. 12.
    Izquierdo Sánchez M, Ochoa Sangrador C, Sánchez Blanco I, Hidalgo Prieto MC, Lozano del Valle F, Martín González T (1997) Epidemiología de la fractura osteoporótica de cadera en la provincia de Zamora (1993). Rev Esp Salud Publica 71:357–367Google Scholar
  13. 13.
    Cabasés Hita JM, Carmona López G, Hernández Vecino R (2000) Incidencia, riesgo y evolución de las fracturas osteoporóticas de cuello de fémur en las mujeres en España, a partir de un modelo de Markov. Med Clin (Barc) 114 [Suppl 2]:63–67Google Scholar
  14. 14.
    Johnell O, Gullberg B, Allander E, Kanis JA, and the MEDOS Study Group (1992) The apparent incidence of hip fracture in Europe: A study of national register sources. Osteoporos Int 2:298–302Google Scholar
  15. 15.
    Gallagher JC, Melton LJ, Riggs BL, Bergstrath E (1980) Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res 150:163–171Google Scholar
  16. 16.
    Boereboom FTJ, Raymakers JA, Groot RRM, Duursma SA (1993) Epidemiology of hip fractures in the Netherlands: women compared with men. Osteoporos Int [Suppl 1]:279–281Google Scholar
  17. 17.
    Swanson AJ, Murdoch G (1983) Fractured neck of femur: pattern of incidence and implications. Acta Orthop Scand 54:348–355Google Scholar
  18. 18.
    Baudoin C, Fardellone P, Potard V, Sebert JL (1993) Fractures of the proximal femur in Picardy, France, in 1987. Osteoporos Int 3:43–49Google Scholar
  19. 19.
    Boyce WJ, Vessey MP (1985) Rising incidence of fractures of the proximal femur. Lancet 1:150–151Google Scholar
  20. 20.
    Jones G, Nguyen T, Sambrook PN, Kelly PJ, Gilbert C, Eisman JA (1994) Symptomatic fracture incidence in elderly men and women: The Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporos Int 4:277–282Google Scholar
  21. 21.
    Serra JA, Garrido G, Vidán M, Marañón E, Brañas F, Ortiz J (1997) Epidemiología de la fractura de cadera en ancianos en España. An Med Interna 19:389–395Google Scholar
  22. 22.
    Hinton RY, Lennox DW, Ebert FR, Jacobsen SJ, Smith GS (1995) Relative rates of fracture of the hip in the United States. Geographic, sex, and age variations. J Bone Joint Surg 77A:695–702Google Scholar
  23. 23.
    Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1990) Hip fracture incidence among the old and very old: a population-based study of 745,435 cases. Am J Public Health 80:871–873Google Scholar
  24. 24.
    Mautalen C, Pumarino H (1997) Epidemiology of osteoporosis in South America. Osteoporos Int 7 [Suppl 3]:S73–77Google Scholar
  25. 25.
    Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho SC, Jónsson PV, Poór G, Sisson de Castro JA, Xu L, Matkin CC, Nelson LM, Heyse SP (1999) International variation in the incidence of hip fractures: Cross-national project on osteoporosis for the World Health Organization program for research on aging. Osteoporos Int 9:242–253Google Scholar
  26. 26.
    Komatsu RS, Jennings-Simoes MF, Ramos LR, Szejnfeld VL (1999) Incidence of fractures of the proximal femur in Marília, São Paulo, Brazil, 1994 and 1995. Rev Bras Reumatol 39:325–331Google Scholar
  27. 27.
    Memon A, Pospula WM, Tantawy AY, Abdul-Ghafar S, Suresh A, Al-Rowaih A (1998) Incidence of hip fracture in Kuwait. Int J Epidemiol 27:860–863Google Scholar
  28. 28.
    Mazzuoli GF, Gennari C, Passeri M, Cali FS, Acca M, Camporeale A, Pioli G, Pedrazzoni M (1993) Incidence of hip fractures: an Italian survey. Osteoporos Int 3 [Suppl 1]:58–59Google Scholar
  29. 29.
    Ramalho AC, Lazaretti-Castro M, Hauache O, Vieira JG, Takata E, Cafalli F, Tavares F (2001) Osteoporotic fractures of proximal femur: Clinical and epidemiological features in a population of the city of São Paulo. Sao Paulo Med J 119:48–53Google Scholar
  30. 30.
    Mautalen C, Vega E (1993) Different characteristics of cervical and trochanteric hip fractures. Osteoporos Int 3 [Suppl 1]:S102–106Google Scholar
  31. 31.
    Michaelson K, Weiderpass E, Farahmand B, Baron J, Persson P, Ziden L, Zetterberg C, Ljunghall S (1999) Differences in risk factor patterns between cervical and trochanteric hip fractures. Osteoporos Int 10:487–494Google Scholar
  32. 32.
    Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ (1985) Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 7:178–208Google Scholar
  33. 33.
    Meier DE, Orwoll ES, Jones JM (1984) Marked disparity between trabecular and cortical bone loss with age in healthy men. Measurement by vertebral computed tomography and radial photon absorptiometry. Ann Intern Med 101:605–612Google Scholar
  34. 34.
    Löfman O, Berglund K, Larsson L, Toss G (2002) Changes in hip fracture epidemiology: Redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25Google Scholar
  35. 35.
    Thorngren KG, Hommel A, Norman PO, Thorngren J, Wingstrand H (2002) Epidemiology of femoral neck fractures. Injury 33 [Suppl 3]:SC1–7Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  1. 1.Chair of Biological Chemistry, School of Medical SciencesNational University of Rosario and Center for the Study of the ClimactericRosarioArgentina
  2. 2.Centro de EndocrinologíaRosarioArgentina

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