Trend of hip fracture incidence in Germany 1995–2004: a population-based study
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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.
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.
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).
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.
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.
KeywordsEpidemiology Hip fracture Incidence Population-based register study Trend analysis
The study was supported by a grant from the North-Rhine Westphalian Ministry of Health and Social Services. We would like the Health Counselling Committee of the North-Rhine Westphalian Chamber of Physicians (Head Dr. Arnold Schüller) for their support. We would further like to thank Dr. Olaf Schoffer, Research Department of the National Statistical Office, for his support in data management, and Prof. Florian Gebhard, Clinic of Surgery, University of Ulm, for his support in interpreting the results.
The study was supported by a grant from the North-Rhine Westphalian Ministry of Health and Social Services.
Conflict of interest statement
All authors declare that they have no conflict of interest.
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