Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop

ArticleinIndian Journal of Orthopaedics 45(1):15-22 · March 2011with62 Reads
DOI: 10.4103/0019-5413.73656 · Source: PubMed
Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates) and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.


    • "A report in 2004 estimated an annual incidence of 600,000 osteoporotic hip fractures in India [8], and this is expected to increase significantly as the percentage of people over 60 years rises from 5.6 % in 1961 to 12 % of 1.36 billion by 2026 [9]. Studies from India on bone health and hip fractures suggest that due to poor bone health and low socioeconomic status, osteoporotic hip fractures are likely to occur a decade earlier in Indian men and women compared to their western counter- parts101112. The length of stay in hospital is about 3 weeks in the UK—and half of elderly adults with hip fractures do not return to their usual place of residence [13]. "
    Full-text · Article · Dec 2016
    Lalit YadavLalit YadavAbha TewariAbha TewariAnil JainAnil Jain+1more author...[...]
    • "A secondary hypothesis is that there has been a change in incidence trends over time from 2000 to 2011. Several factors may be associated with hip fracture incidence such as age, gender, and race/ethnicity [1, 10]. California is a diverse state and provides an opportunity to examine these factors in relation to incidence of hip fracture and mortality following a hip fracture. "
    [Show abstract] [Hide abstract] ABSTRACT: Hip fractures result in both health and cost burdens from a public health perspective and have a major impact on the health care system in the USA. The purpose was to examine whether there were systematic differences in hip fracture incidence and 30-, 90-, and 365-day mortality after hip fracture in the California population as a function of age, gender, and race/ethnicity from 2000–2011. This was a population-based study from 2000 to 2011 using data from the California Office of Statewide Health and Planning and Development (OSHPD, N = 317,677), California State Death Statistical Master File records (N = 224,899), and the US Census 2000 and 2010. There were a total of 317,677 hospital admissions for hip fractures over the 12-year span and 24,899 deaths following hip fractures. All participants without linkage (substituted for social security) numbers were excluded from mortality rate calculations. Variation in incidence and mortality rates across time, gender, race/ethnicity, and age were assessed using Poisson regression models. Odds ratio and 95 % confidence intervals are provided. The incidence rate of hip fractures decreased between 2000 and 2011 (odds ratio (OR) = 0.98, 95 % confidence interval (CI) 0.98, 0.98). Mortality rates also decreased over time. There were gender, race/ethnicity, and age group differences in both incidence and mortality rates. Males were half as likely to sustain a hip fracture, but their mortality within a year of the procedure is almost twice the rate than women. As age increased, the prevalence of hip fracture increased dramatically, but mortality did not increase as steeply. Caucasians were more likely to sustain a hip fracture and to die within 1 year after a hip fracture. The disparities in subpopulations will allow for targeted population interventions and opportunities for further research.
    Full-text · Article · Dec 2016
    • "Hip fractures are one of the most important causes of longterm disability and a significant public health issue [1] . Incidence varies on a global scale [2, 3] but incidence is estimated to vary between 414 and 957 per 100,000 inhabitants in the USA [4]. Due to aging of the population in general a significant increase in hip fracture numbers is expected [5]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: The number of hip fractures and resulting post-surgical outcome are a major public health concern and the incidence is expected to increase significantly. The acute recovery phase after hip fracture surgery in elder patients is often complicated by severe pain, high morphine consumption, perioperative blood loss with subsequent transfusion and delirium. Postoperative continuous-flow cryocompression therapy is suggested to minimize these complications and to attenuate the inflammatory reaction that the traumatic fracture and subsequent surgical trauma encompass. Based on a pilot study in patients undergoing total hip arthroplasty for osteoarthritis, it is anticipated that patients treated with continuous-flow cryocompression therapy will have less pain, less morphine consumption and lower decrease of postoperative hemoglobin levels. These factors are associated with a shorter hospital stay and better long-term (functional) outcome. Methods/design: One hundred and sixty patients with an intra or extracapsular hip fracture scheduled for internal fixation (intramedullary hip nail, dynamic hip screw or cannulated screws) or prosthesis surgery (total hip or hemiarthroplasty) will be included in this prospective, open-label, parallel, multicenter, randomized controlled, clinical superiority trial. Patients will be allocated to two treatment arms: group 'A' will be treated with continuous-flow cryocompression therapy and compared to group 'B' that will receive standard care. Routine use of drains and/or compressive bandages is allowed in both groups. The primary objective of this study is to compare acute pain the first 72 h postoperative, measured with numeric rating scale for pain. Secondary objectives are: (non-) morphine analgesic use; adjusted postoperative hemoglobin level; transfusion incidence; incidence, duration and severity of delirium and use of psychotropic medication; length of stay; location and duration of rehabilitation; functional outcome; short-term patient-reported health outcome; general and cryotherapy related complications and feasibility. Discussion: This is the first randomized controlled trial that will assess the analgesic efficiacy of continuous-flow cryocompression therapy in the acute recovery phase after hip fracture surgery. Trial registration: www.trialregister.nl , NTR4152 (23(rd) of August 2013).
    Full-text · Article · Dec 2016
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