Epidemiology and social costs of hip fracture

doi:10.1016/j.injury.2018.04.015

Injury

Volume 49, Issue 8, August 2018, Pages 1458-1460

https://doi.org/10.1016/j.injury.2018.04.015 Get rights and content

Abstract

Hip fracture is an important and debilitating condition in older people, particularly in women. The epidemiological data varies between countries, but it is globally estimated that hip fractures will affect around 18% of women and 6% of men. Although the age-standardised incidence is gradually falling in many countries, this is far outweighed by the ageing of the population. Thus, the global number of hip fractures is expected to increase from 1.26 million in 1990 to 4.5 million by the year 2050. The direct costs associated with this condition are enormous since it requires a long period of hospitalisation and subsequent rehabilitation. Furthermore, hip fracture is associated with the development of other negative consequences, such as disability, depression, and cardiovascular diseases, with additional costs for society.

In this review, we show the most recent epidemiological data regarding hip fracture, indicating the well-known risk factors and conditions that seem relevant for determining this condition. A specific part is dedicated to the social costs due to hip fracture. Although the costs of hip fracture are probably comparable to other common diseases with a high hospitalisation rate (e.g. cardiovascular disease), the other social costs (due to onset of new co-morbidities, sarcopenia, poor quality of life, disability and mortality) are probably greater.

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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This randomized clinical trial was conducted on the patients referring to an institutional tertiary hospital in northwestern Iran between March 2020 and June 2021. The patients' preoperative, perioperative, and postoperative characteristics were evaluated for at least two years. Primary endpoints were defined as the incidence of hip-related complications, while secondary endpoints were assessed based on the patients’ hip function using Harris Hip Score (HHS).
Fifty-seven patients with osteoporosis and UIFNF were included in the final analysis, with 27 patients in the NCS group and 30 patients in the CS group. The surgical duration, the amount of intraoperative blood loss, and the frequency of C-arm were considerably lower in the CS group (p < 0.05). The incidence of implant failure was higher in the NCS group (p = 0.04). Screw migration occurred more frequently in the CS group (p = 0.03). The HHS values were significantly higher for the NCS group than those of the CS group at both the 1-year and 2-years of follow-up assessments (1 year, p = 0.007; 2 years, p = 0.001).
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Epidemiology and social costs of hip fracture

Abstract

Introduction

Section snippets

Pathogenesis

Epidemiology of hip fracture

Social costs

Conclusions

Conflict of interest

Funding

Injury

Am J Med

Am J Geriatr Psychiatry

Incidence of hip fractures in the elderly: a cross-national analysis

Osteoporos Int

Orthogeriatrics

Epidemiology of Hip Fracture and Social Costs

Risk factors for osteoporosis

Aust N Z J Med

Epidemiology and outcomes of osteoporotic fractures

Lancet

Vitamin D status in anorexia nervosa: a meta-analysis

Int J Eat Disord

Bone mineral density, osteoporosis, and fractures among people with eating disorders: a systematic review and meta-analysis

Acta Psychiatr Scand

Body mass index as a predictor of fracture risk: a meta-analysis

Osteoporos Int

Dietary patterns and fractures in postmenopausal women

JAMA Intern Med

Osteoporosis: fracture epidemiologyupdate 2016

Curr Opin Rheumatol

Hip fractures in the elderly: a world-wide projection

Osteoporos Int

A systematic review of hip fracture incidence and probability of fracture worldwide

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