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Urban versus rural differences of hip fractures among the elderly in Kyoto, Japan: a 10-year study

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Abstract

Summary

Secular changes in the incidence rate of hip fractures were estimated to vary by fracture type, i.e., femoral neck or trochanteric fractures, age, and sex, in urban or rural areas in Kyoto Prefecture, Japan from 2008 to 2017.

Purpose

Our survey in Kyoto Prefecture from 2008 to 2017 showed that the incidence rate of femoral neck fractures is generally increasing. We investigated the differences between urban and rural areas in the changes of the incidence rate over time of femoral neck and trochanteric fractures during the same period.

Methods

Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The ratio of sick beds for acute-term care at the investigated hospitals to total number of beds in the urban area was 16.5% (1863/11,158) and 30.6% (1863/5623) in the rural area. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015.

Results

There were 3559 and 6474 hip fractures in the urban and rural areas, respectively. Femoral neck fractures were 1936 (54.4%) and 2813 (43.5%) in each area. The increase of the population-adjusted numbers was marked by neck fractures in males, in both areas. In women, there was a significant increase in femoral neck fractures in the urban area in those aged 85 years and over. For trochanteric fractures, a significant increase was only found in women aged 65 to 74 years in the rural area.

Conclusion

A regional difference in the secular changes in incidence rate of hip fractures was found in women, not in men, mostly because neck fractures in women increased in the over 85 group in the urban area.

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References

  1. Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767. https://doi.org/10.1016/s0140-6736(02)08657-9

    Article  PubMed  Google Scholar 

  2. Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390. https://doi.org/10.7326/0003-4819-152-6-201003160-00008

    Article  PubMed  PubMed Central  Google Scholar 

  3. Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen I, Kristiansen IS (2004) Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int 15(7):567–574. https://doi.org/10.1007/s00198-003-1583-0

    Article  CAS  PubMed  Google Scholar 

  4. Rohde G, Haugeberg G, Mengshoel AM, Moum T, Wahl AK (2010) Two-year changes in quality of life in elderly patients with low-energy hip fractures. A case-control study. BMC Musculoskelet Disord 11:226. https://doi.org/10.1186/1471-2474-11-226

    Article  PubMed  PubMed Central  Google Scholar 

  5. Veronese N, Maggi S (2018) Epidemiology and social costs of hip fracture. Injury 49(8):1458–1460. https://doi.org/10.1016/j.injury.2018.04.015

    Article  PubMed  Google Scholar 

  6. Orimo H, Yaegashi Y, Hosoi T, Fukushima Y, Onoda T, Hashimoto T, Sakata K (2016) Hip fracture incidence in Japan: estimates of new patients in 2012 and 25-year trends. Osteoporos Int 27(5):1777–1784. https://doi.org/10.1007/s00198-015-3464-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hagino H, Endo N, Harada A, Iwamoto J, Mashiba T, Mori S, Ohtori S, Sakai A, Takada J, Yamamoto T (2017) Survey of hip fractures in Japan: recent trends in prevalence and treatment. J Orthop Sci 22(5):909–914. https://doi.org/10.1016/j.jos.2017.06.003

    Article  PubMed  Google Scholar 

  8. Asada M, Horii M, Ikoma K, Goto T, Okubo N, Kuriyama N, Takahashi K (2021) Hip fractures among the elderly in Kyoto, Japan: a 10-year study. Arch Osteoporos 16(1):30. https://doi.org/10.1007/s11657-021-00888-8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Horii M, Fujiwara H, Ikeda T, Ueshima K, Ikoma K, Shirai T, Terauchi R, Nagae M, Kuriyama N, Kubo T (2013) Urban versus rural differences in the occurrence of hip fractures in Japan’s Kyoto prefecture during 2008–2010: a comparison of femoral neck and trochanteric fractures. BMC Musculoskelet Disord 14:304. https://doi.org/10.1186/1471-2474-14-304

    Article  PubMed  PubMed Central  Google Scholar 

  10. Nationwide survey of hip fractures in Japan (2004). J Orthop Sci 9 (1):1–5. https://doi.org/10.1007/s00776-003-0741-8

  11. Michaëlsson K, Weiderpass E, Farahmand BY, Baron JA, Persson PG, Zidén L, Zetterberg C, Ljunghall S (1999) Differences in risk factor patterns between cervical and trochanteric hip fractures. Swedish Hip Fracture Study Group. Osteoporos Int 10(6):487–494. https://doi.org/10.1007/s001980050259

    Article  PubMed  Google Scholar 

  12. Pulkkinen P, Glüer CC, Jämsä T (2011) Investigation of differences between hip fracture types: a worthy strategy for improved risk assessment and fracture prevention. Bone 49(4):600–604. https://doi.org/10.1016/j.bone.2011.07.022

    Article  PubMed  Google Scholar 

  13. Horii M, Fujiwara H, Sakai R, Sawada K, Mikami Y, Toyama S, Ozaki E, Kuriyama N, Kurokawa M, Kubo T (2017) New quantitative ultrasound techniques for bone analysis at the distal radius in hip fracture cases: differences between femoral neck and trochanteric fractures. Clin Cases Miner Bone Metab 14(1):23–27. https://doi.org/10.11138/ccmbm/2017.14.1.023

    Article  PubMed  PubMed Central  Google Scholar 

  14. Määttä M, Terho E, Jokinen H, Pulkkinen P, Korpelainen J, Heikkinen J, Keinänen-Kiukaanniemi S, Jämsä T, Korpelainen R (2012) Lifestyle factors and site-specific risk of hip fracture in community dwelling older women–a 13-year prospective population-based cohort study. BMC Musculoskelet Disord 13:173. https://doi.org/10.1186/1471-2474-13-173

    Article  PubMed  PubMed Central  Google Scholar 

  15. Abrahamsen B, Laursen HVB, Skjødt MK, Jensen MH, Vestergaard P (2020) Age at hip fracture and life expectancy in Denmark - secular trends over two decades. Bone 130:115083. https://doi.org/10.1016/j.bone.2019.115083

    Article  PubMed  Google Scholar 

  16. Crisp A, Dixon T, Jones G, Cumming RG, Laslett LL, Bhatia K, Webster A, Ebeling PR (2012) Declining incidence of osteoporotic hip fracture in Australia. Arch Osteoporos 7:179–185. https://doi.org/10.1007/s11657-012-0095-y

    Article  PubMed  Google Scholar 

  17. Hawley S, Leal J, Delmestri A, Prieto-Alhambra D, Arden NK, Cooper C, Javaid MK, Judge A (2016) Anti-osteoporosis medication prescriptions and incidence of subsequent fracture among primary hip fracture patients in England and Wales: an interrupted time-series analysis. J Bone Miner Res 31(11):2008–2015. https://doi.org/10.1002/jbmr.2882

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

All authors would like to thank the following for their invaluable help and contribution to the study by registering their cases at each institution:

North Medical Center Kyoto Prefectural University of Medicine

Maizuru Red Cross Hospital

Fukuchiyama City Hospital

Ayabe City Hospital

Kyoto Chubu Medical Center

Japanese Red Cross Kyoto Daiichi Hospital

Japanese Red Cross Kyoto Daini Hospital

Rakuwakai Marutamachi Hospital

Kyoto Kuramaguchi Medical Center

Kyoto Kizugawa Hospital

Tanabe Central Hospital

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Naoki Okubo, Motoyuki Horii, Kazuya Ikoma, Maki Asada, Tsuyoshi Goto & Kenji Takahashi

  2. Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Motoyuki Horii

  3. Rakuwakai Otowa Rehabilitation Hospital, Kyoto, Japan

    Motoyuki Horii & Maki Asada

  4. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Nagato Kuriyama

  5. Shizuoka Graduate University of Public Health, Shizuoka, Japan

    Nagato Kuriyama

Authors
  1. Naoki Okubo
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  2. Motoyuki Horii
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  3. Kazuya Ikoma
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  4. Maki Asada
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  5. Tsuyoshi Goto
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  6. Nagato Kuriyama
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  7. Kenji Takahashi
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Contributions

MH, KI, MA, NK, and KT contributed to the conception and design of the study. NO, MH, MA, and TG participated in data collection. MH, NO, and NK performed the statistical analysis. NO, MH, KI, and MA drafted the manuscript. All authors read and approved the final manuscript. MA did the English editing.

Corresponding author

Correspondence to Naoki Okubo.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the ethics committee of the Kyoto Prefectural University of Medicine.

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For this type of study, formal consent is not required.

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Okubo, N., Horii, M., Ikoma, K. et al. Urban versus rural differences of hip fractures among the elderly in Kyoto, Japan: a 10-year study. Arch Osteoporos 16, 160 (2021). https://doi.org/10.1007/s11657-021-01029-x

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  • DOI: https://doi.org/10.1007/s11657-021-01029-x

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