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. 2023 Aug;38(8):1064-1075.
doi: 10.1002/jbmr.4821. Epub 2023 May 29.

Global Epidemiology of Hip Fractures: Secular Trends in Incidence Rate, Post-Fracture Treatment, and All-Cause Mortality

Chor-Wing Sing  1 , Tzu-Chieh Lin  2 , Sharon Bartholomew  3 , J Simon Bell  4 , Corina Bennett  2 , Kebede Beyene  5 , Pauline Bosco-Levy  6 , Brian D Bradbury  2 , Amy Hai Yan Chan  7 , Manju Chandran  8 , Cyrus Cooper  9 , Maria de Ridder  10 , Caroline Y Doyon  3 , Cécile Droz-Perroteau  6 , Ganga Ganesan  11 , Sirpa Hartikainen  12 , Jenni Ilomaki  4 , Han Eol Jeong  13 , Douglas P Kiel  14 , Kiyoshi Kubota  15 , Edward Chia-Cheng Lai  16 , Jeff L Lange  2 , E Michael Lewiecki  17 , Julian Lin  12 , Jiannong Liu  18 , Joe Maskell  2 , Mirhelen Mendes de Abreu  19 , James O'Kelly  2 , Nobuhiro Ooba  20 , Alma B Pedersen  21 , Albert Prats-Uribe  22 , Daniel Prieto-Alhambra  22 , Simon Xiwen Qin  1 , Ju-Young Shin  13 , Henrik T Sørensen  21 , Kelvin Bryan Tan  23 , Tracy Thomas  2 , Anna-Maija Tolppanen  12 , Katia M C Verhamme  10 , Grace Hsin-Min Wang  16 , Sawaeng Watcharathanakij  24 , Stephen J Wood  4 , Ching-Lung Cheung  1 , Ian C K Wong  1   25
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Free article

Global Epidemiology of Hip Fractures: Secular Trends in Incidence Rate, Post-Fracture Treatment, and All-Cause Mortality

Chor-Wing Sing et al. J Bone Miner Res. 2023 Aug.
Free article

Abstract

In this international study, we examined the incidence of hip fractures, postfracture treatment, and all-cause mortality following hip fractures, based on demographics, geography, and calendar year. We used patient-level healthcare data from 19 countries and regions to identify patients aged 50 years and older hospitalized with a hip fracture from 2005 to 2018. The age- and sex-standardized incidence rates of hip fractures, post-hip fracture treatment (defined as the proportion of patients receiving anti-osteoporosis medication with various mechanisms of action [bisphosphonates, denosumab, raloxifene, strontium ranelate, or teriparatide] following a hip fracture), and the all-cause mortality rates after hip fractures were estimated using a standardized protocol and common data model. The number of hip fractures in 2050 was projected based on trends in the incidence and estimated future population demographics. In total, 4,115,046 hip fractures were identified from 20 databases. The reported age- and sex-standardized incidence rates of hip fractures ranged from 95.1 (95% confidence interval [CI] 94.8-95.4) in Brazil to 315.9 (95% CI 314.0-317.7) in Denmark per 100,000 population. Incidence rates decreased over the study period in most countries; however, the estimated total annual number of hip fractures nearly doubled from 2018 to 2050. Within 1 year following a hip fracture, post-hip fracture treatment ranged from 11.5% (95% CI 11.1% to 11.9%) in Germany to 50.3% (95% CI 50.0% to 50.7%) in the United Kingdom, and all-cause mortality rates ranged from 14.4% (95% CI 14.0% to 14.8%) in Singapore to 28.3% (95% CI 28.0% to 28.6%) in the United Kingdom. Males had lower use of anti-osteoporosis medication than females, higher rates of all-cause mortality, and a larger increase in the projected number of hip fractures by 2050. Substantial variations exist in the global epidemiology of hip fractures and postfracture outcomes. Our findings inform possible actions to reduce the projected public health burden of osteoporotic fractures among the aging population. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Keywords: EPIDEMIOLOGY; FRACTURE PREVENTION; HIP FRACTURE; MORTALITY; OSTEOPOROSIS.

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References

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