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Review
. 2019 Feb;52(1):10-16.
doi: 10.1007/s00391-018-1382-z. Epub 2018 Mar 28.

Epidemiology of hip fractures : Systematic literature review of German data and an overview of the international literature

Kilian Rapp  1   2 , Gisela Büchele  3 , Karsten Dreinhöfer  4   5 , Benjamin Bücking  6 , Clemens Becker  7 , Petra Benzinger  7
Affiliations
Review

Epidemiology of hip fractures : Systematic literature review of German data and an overview of the international literature

Kilian Rapp et al. Z Gerontol Geriatr. 2019 Feb.

Abstract
in English, German

Background: Hip fractures are regarded as a worldwide epidemic and a major public health concern. Changing risk factors, local differences and temporal trends contribute to the particular epidemiology of hip fractures. This overview gives a comprehensive insight into the epidemiology of hip fractures and reviews where German data have contributed to the literature.

Methods: The review of the epidemiology of hip fractures in Germany is based on a systematic literature search in PubMed. Information about the global epidemiology of hip fractures was provided by a selective literature review focusing on specific aspects of the epidemiology of hip fractures.

Results: Hip fracture rates vary more than 100-fold between different countries. In most high-income countries, a rise in age-standardized hip fracture rates was observed until the 1980s and 1990s and a decrease thereafter. Such a decrease has not been observed for Germany so far. Many factors, diseases and drugs have been found to be associated with hip fractures and there is some evidence that fracture risk in later life is already programmed during fetal life and early childhood. Of the hip fracture burden 50% occur in people with disability and in need of care. In nursing homes approximately 4 fractures can be expected in 100 women per year. In people with intellectual or developmental disabilities comparable risks of hip fracture occur 10-40 years earlier than in the general population. Incidence of disability, institutionalization and death are frequent consequences of hip fractures.

Conclusion: The epidemiology of hip fractures is characterized by a high burden of disease, local differences, temporal trends, well-defined high-risk populations and many established risk factors.

Hintergrund: Hüftfrakturen werden weltweit als eines der großen Gesundheitsprobleme angesehen. Diese Übersicht vermittelt einen umfassenden Einblick in die Hüftfrakturepidemiologie und zeigt, wo deutsche Daten neue Erkenntnisse hinzugefügt haben.

Methode: Das Review zur deutschen Hüftfrakturepidemiologie basiert auf einer systematischen Literatursuche in PubMed. Informationen zu spezifischen Teilaspekten der globalen Hüftfrakturepidemiologie beruhen auf einer selektiven Literatursuche.

Ergebnisse: Hüftfrakturraten unterscheiden sich um mehr als das 100-fache zwischen verschiedenen Ländern. In den meisten westlichen Industriestaaten wurde ein Anstieg der altersstandardisierten Raten bis in die 80er- und 90er-Jahre und ein Rückgang in den Folgejahren beobachtet. In Deutschland wurde bisher kein Rückgang der Hüftfrakturrate beobachtet. Hüftfrakturen treten in 50 % der Fälle bei Personen mit Pflegebedürftigkeit auf. In Pflegeheimen muss jährlich mit 4 Hüftfrakturen pro 100 Bewohnern gerechnet werden. Bei Personen mit geistiger Behinderung treten Hüftfrakturen 10 bis 40 Jahre früher auf als in der Allgemeinbevölkerung. Pflegebedürftigkeit, Institutionalisierung und Tod sind häufige Folgen von Hüftfrakturen.

Schlussfolgerung: Die Hüftfrakturepidemiologie ist durch eine hohe Krankheitslast, geographische Unterschiede, zeitliche Veränderungen, Hochrisikopopulationen und eine Reihe etablierter Risikofaktoren charakterisiert.

Keywords: Institutionalization; Intellectual disability; Mortality; Prevention; Risk factors.

PubMed Disclaimer

Conflict of interest statement

K. Rapp, G. Büchele, K. Dreinhöfer, B. Bücking, C. Becker and P. Benzinger declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Incidence rate of fractures as a function of time since admission to a nursing home for all fractures combined and femoral fractures. (Data from Rapp et al. [26])
Fig. 2
Fig. 2
Femoral fracture rates in women stratified by setting (community-dwelling people without care needs, community-dwelling people with care needs and residents of nursing homes) and age. (Data from Rapp et al. [5])
Fig. 3
Fig. 3
Rates of institutionalization within 6 months after discharge from hospital in men with femoral fracture, stroke, myocardial infarction, pneumonia and other reasons for hospitalization in different age categories. (Data from Rapp et al. [57])
See this image and copyright information in PMC

References

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