Emerging trends in hospitalisation for fragility fractures in Ireland

Abstract

Background: We analysed hospital admissions and bed occupancy for fragility fractures in Ireland over a 15-year period to assess fracture admission trends and to project admissions over the next three decades.

Methods: We used the Hospital In-Patient Enquiry (HIPE) scheme to extract data on fracture admissions to Irish hospitals between 2000 and 2014 inclusive. We calculated absolute numbers and age-standardised rates of hospitalisations for men and women ≥ 50 years for each osteoporotic-type fracture. We projected fracture numbers and bed days using these trends, and associated costs to 2046 based on 2014 rates.

Results: The absolute number of all fragility fracture admissions increased by 30% between 2000 and 2014, for both men (40%) and women (27%). In-patient bed days for osteoporotic fractures have increased by 51% in the same period. Hip fractures dominated admissions, accounting for 36.5% of all admissions and almost half (46.7%) of all bed days. Age-standardised rates of hip fracture admission decreased significantly (p < 0.001) in women, but not in men, while rates of non-hip osteoporotic fracture admissions have not changed significantly for men or women. Hospitalisations for all osteoporotic fractures are projected to increase by 150% to 31,605 in 2046, 58% of whom will be 80 years or older.

Conclusions: There has been a significant increase in the number of fracture admissions in Irish men and women over the past 15 years. This is projected to increase further over the next three decades which will place a significant burden on the Irish healthcare system.

Keywords: Fracture; Hip fracture; Osteoporosis; Trend analysis.