The prevalence of hospitalisations for osteoporotic (non-traumatic) hip fractures in the USA declined significantly from 1988 to 2005, despite an increase in all-cause hospitalisations over the same period and a general ageing of the population, according to research presented June 12 at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France.
Over the period in question, (1988-2005), a rapid growth in the elderly US population has occurred and epidemiologists and economists had predicted that the prevalence of osteoporotic hip fractures would also escalate , given that they are more often seen in the aged demographic. In the US, the proportion of population aged 50 years or older increased from 25.6% in 1988 to 29.4% in 2005, an increase of 14.7%.
The total number of all-cause hospitalisations in this age group increased from 16.2 million in 1988 to 20 million in 2005, whereas the prevalence of non-traumatic hip fracture hospitalisations in this population decreased from 428 per 100,000 population to 328 per 100,000 in 2005, a decline of 25%. Similarly, as a proportion of all hospitalisations, those directly related to non-traumatic hip fractures decreased from 1.7% of total in 1988 to 1.4% in 2005.
Of all of the common osteoporotic fractures (which are most often seen in the spine, hip or wrist), hip fractures are generally associated with the highest morbidity, mortality and burden on healthcare resources, given that patients may require multidisciplinary care, long periods of convalescence and long-term social care following discharge from hospital.
Ms Amrita Sehgal, a 17-year old student at Menlo-Atherton High School, Woodside, USA, who led the study, said of the results: "It is very interesting that the prevalence of hip fracture hospitalisations decreased so dramatically during this period. This decrease is likely is due to a combination of improved awareness, screening, early diagnosis and treatment. Hopefully we will be able to build upon such advances to further decrease this rate, improve patient prognosis and reduce the impact of osteoporosis overall."
Investigators in this study examined the Nationwide Inpatient Sample (NIS), a stratified random sample of all US community hospitals, the only US national hospital database with information on all patients regardless of payer, held between 1988 and 2005. Inpatients with a primary or secondary diagnosis of non-traumatic hip fracture, were compared with total all-cause US hospitalisations, thus adjusting for secular trends. US population estimates and projections for the resident US population were obtained from the US Census Bureau.
Reference: Cooper S., Osteoporosis International, 1992; 2:285-9; Osteoporosis Int 1997; 7:407-13
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