Epidemiology and social costs of hip fracture
Introduction
Hip fractures constitute a significant public health issue [1]. Prediction of future numbers of hip fracture patients is necessary in order to be as prepared as possible for the increased burden on the health care and social services, especially in areas of the world where unprecedented rapid rises will be seen, due to the trajectory of their population’s ageing.
Section snippets
Pathogenesis
The pathogenesis of hip fractures is multifactorial, but the risk factors for this condition can roughly be divided into those decreasing bone mineral density (BMD) and those increasing the rate of falls [2], [3].
The factors negatively affecting BMD can be categorised as non-modifiable or modifiable factors [4], [5]. In the first category, we can include genetic predisposition to low BMD/osteoporosis, older age, female sex, family history of osteoporosis/fractures, and low body frame size.
Epidemiology of hip fracture
In 1992, the International Osteoporosis Foundation (IOF) suggested that worldwide hip fractures occurred in 18% of women and 6% in men [11]. Their more recent data (2012) showed that the highest incidence of hip fracture was observed in Denmark (439/100,000), the lowest in Ecuador (55/100,000) [12]. The most common site affected is the femoral neck, although intertrochanteric fractures are very similar in frequency in older patients, with a higher incidence in white women than in men [13].
The
Social costs
It is noteworthy that every year about 300,000 subjects are hospitalised for hip fractures in the United States alone [34]. The estimated cost of treatment in the US was approximately 10.3 to 15.2 billion dollars per year in 1990 [35] and 17 billion in 2002 [5].
The costs due to hip fracture come from several aspects including those associated with hospitalisation, rehabilitation, placement in nursing home, and other costs.
The data available suggest that hip fracture is associated with high
Conclusions
Hip fracture is a common condition, leading to disability and consequently mortality. The data regarding its epidemiology are variable and some non-modifiable factors (such as age, race and sex) affect its incidence. Altogether, the global incidence of hip fracture is rising, underlining the need for focussing on its prevention, which is possible through the treatment of osteoporosis and falls risk.
Conflict of interest
The authors have no conflict of interest to declare.
Funding
None.
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