European Journal of Epidemiology

, Volume 27, Issue 10, pp 807–814 | Cite as

Hip fractures in Norway 1999–2008: time trends in total incidence and second hip fracture rates. A NOREPOS study

  • Tone K. Omsland
  • Kristin Holvik
  • Haakon E. Meyer
  • Jacqueline R. Center
  • Nina Emaus
  • Grethe S. Tell
  • Berit Schei
  • Aage Tverdal
  • Clara G. Gjesdal
  • Guri Grimnes
  • Siri Forsmo
  • John A. Eisman
  • Anne Johanne Søgaard


Declining incidences of hip fractures are reported from western countries. Norway has among the highest rates in the world. The aim of this study was to investigate trends in total hip fracture rates in Norway between 1999 and 2008 and risk of second hip fractures. All hospitalizations given a hip fracture diagnosis code (International Classification of Diseases (ICD) 9 or ICD 10) (cervical, trochanteric or subtrochanteric) in Norwegian hospitals were retrieved with accompanying surgical procedure codes and additional diagnoses. A total of 93,123 hip fractures were identified between 1999 and 2008 in persons ≥50 years. Annual incidences of hip fractures were calculated and tested for trends. Rates of first and second hip fractures (2006–2008) were compared. The age-standardized total incidence of hip fracture decreased by 13.4 % (95 % confidence interval (CI): 11.0–15.6) in women and 4.8 % (95 % CI: 0.7, 8.7) in men. Age-adjusted rates of second hip fractures did not change in the observation period. In those with a prior hip fracture, the age-standardized risk of a subsequent hip fracture was 2.5-fold (95 % CI: 2.5, 2.6) in women, and 4.6-fold (95 % CI: 4.5, 4.7) in men. Total hip fracture rates declined in both genders during 1999–2008, whereas rates of second hip fractures did not change.


Hip fracture Incidence Osteoporosis Norway Women Men 



The authors are deeply grateful to system architect monitoring Tomislav Dimoski at The Norwegian Knowledge Centre for the Health Services who developed the system that enabled extraction and transfer of data from PAS. He and his team also carried through the collection of the hip fracture data. Senior advisor Dominic Hoff at the Norwegian Institute of Public Health helped with data processing. The authors thank the staff at the Department of Pharmacoepidemiology (Norwegian Institute of Public Health), and Sverre Bjarte Johnsen (Statistics Norway) for assisting in transferring the data to the Norwegian Institute of Public Health and in the encryption process. Hip fracture data for validation of the NOREPOS Hip Fracture Database were obtained from local fracture registries in Tromsø and Oslo, and the authors thank the study investigators for their permission to use these data. This study was supported by a grant from the Research Council of Norway.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10654_2012_9711_MOESM1_ESM.doc (36 kb)
Supplementary table Total number of hip fractures1999–2008 in five year age groups in women and men. The NOREPOS Hip Fracture Database 1999–2008 (DOC 35 kb)
10654_2012_9711_MOESM2_ESM.pdf (214 kb)
Supplementary material 2 (PDF 213 kb)


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Tone K. Omsland
    • 1
    • 2
  • Kristin Holvik
    • 1
    • 2
  • Haakon E. Meyer
    • 1
    • 3
  • Jacqueline R. Center
    • 4
  • Nina Emaus
    • 2
    • 5
  • Grethe S. Tell
    • 2
  • Berit Schei
    • 6
    • 7
  • Aage Tverdal
    • 1
  • Clara G. Gjesdal
    • 8
    • 9
  • Guri Grimnes
    • 10
    • 11
  • Siri Forsmo
    • 7
  • John A. Eisman
    • 4
  • Anne Johanne Søgaard
    • 1
  1. 1.Division of EpidemiologyNorwegian Institute of Public HealthOsloNorway
  2. 2.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway
  3. 3.Department of Community Medicine, Institute of Health and SocietyUniversity of OsloOsloNorway
  4. 4.Osteoporosis and Bone Biology ProgramGarvan Institute of Medical ResearchSydneyAustralia
  5. 5.Department of Health and Care SciencesUniversity of TromsøTromsøNorway
  6. 6.Department of Obstetrics and Gynecology, Faculty of MedicineSt. Olav’s University HospitalTrondheimNorway
  7. 7.Department of Public Health and General Practice, Faculty of MedicineNorwegian University of Science and Technology (NTNU)TrondheimNorway
  8. 8.Department of RheumatologyHaukeland University HospitalBergenNorway
  9. 9.Section of Rheumatology, Institute of MedicineUniversity of BergenBergenNorway
  10. 10.Division of Internal MedicineUniversity Hospital of North NorwayTromsøNorway
  11. 11.Tromsø Endocrine Research Group, Department of Clinical MedicineUniversity of TromsøTromsøNorway

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