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Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality

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Abstract

Summary

The objective of this study was to describe the incidence and consequences of pelvic fractures in a community cohort. The incidence of pelvic fractures increases with age with a protective effect of higher body mass index. Almost 60% of those with a pelvic fracture required an inpatient stay, with a median of 9 days. There was a higher 3-year mortality in those admitted (17%) vs. those not admitted (6.3%). Given the substantial health burden, further work is required to identify the optimal post-fracture therapeutic strategy to improve outcomes.

Introduction

The burden of pelvis fractures is projected to increase, but there is a paucity of community-based studies describing rates, mortality and future fracture risk. We therefore estimated the age, gender and BMI-specific incidence of pelvis fracture in Catalonia (North-East Spain), and assessed hospital stay and mortality following fracture.

Methods

The SIDIAPQ database contains validated clinical information from computerised medical records of a representative sample of 30% of the population of Catalonia. We conducted a retrospective cohort study including all subjects aged ≥40 in SIDIAPQ and linked to the regional Hospital Admissions Database from 2007 to 2009. Pelvis fractures were ascertained using ICD-10 codes. Incidence and mortality rates were calculated.

Results

A total of 1,118,173 patients (582,820 women) were observed for 3 years and 1,356 had a pelvic fracture. The rate for pelvic fracture was 4.35/10,000 person-years (pyar) [95% CI 4.13–4.59] (men—2.73 [2.48–3.01]; women—5.82 [5.46–6.20]). This increased with age, peaking in those over 90 years: 29.41 [25.74–33.59]. Higher BMI was protective (HR 0.75 per SD BMI; [0.69–0.82]). Moreover, 59.1% of fractured patients were hospitalised with a median (IQR) stay of 9 (5–16) days, and after the 3-year follow-up 13.9% died (mortality rate 10.7/100 pyar [9.3–12.3]) with higher rates in those hospitalised (17.0%).

Conclusions

Pelvic fractures are associated with high rates of hospitalisation and mortality. Given this, further work is required to identify the optimal post-fracture therapeutic strategy to improve outcomes in this elderly patient group.

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Authors and Affiliations

  1. Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK

    D. Prieto-Alhambra, A. Judge, N. K. Arden, C. Cooper & M. K. Javaid

  2. Institut Català de la Salut—IDIAP Jordi Gol i Gurina, Barcelona, Spain

    D. Prieto-Alhambra & F. F. Avilés

  3. URFOA–IMIM, Internal Medicine Department (Parc de Salut Mar) and RETICEF (Instituto de Salud Carlos III-FEDER), Barcelona, Spain

    D. Prieto-Alhambra, X. Nogués & A. Díez-Pérez

  4. Universitat Autònoma de Barcelona, Barcelona, Spain

    D. Prieto-Alhambra, X. Nogués & A. Díez-Pérez

  5. General Practice Research Database, Medicines and Healthcare Products Regulatory Agency, London, UK

    T. Van Staa

  6. Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands

    T. Van Staa

  7. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK

    C. Cooper

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  1. D. Prieto-Alhambra
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  2. F. F. Avilés
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  3. A. Judge
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  4. T. Van Staa
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  6. N. K. Arden
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  7. A. Díez-Pérez
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  8. C. Cooper
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  9. M. K. Javaid
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Corresponding author

Correspondence to M. K. Javaid.

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Prieto-Alhambra, D., Avilés, F.F., Judge, A. et al. Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality. Osteoporos Int 23, 2797–2803 (2012). https://doi.org/10.1007/s00198-012-1907-z

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  • DOI: https://doi.org/10.1007/s00198-012-1907-z

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