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Incidence of hip fractures in Germany, 1995–2010

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Abstract

Summary

We analyzed hip fracture incidence trends in Germany in 1995–2010, using national hospital discharge register. Overall, after age–sex–region adjustment, there was no significant trend. However, stratified analyses showed a significant decrease in younger people. In the elderly, there was a moderate increase in men and decrease in women. Incidences were still higher in Western Germany (each significant).

Background

Whereas most studies from US and European countries found trends of a decreasing hip fracture incidence in the last years, in Germany, an increase has been still observed up to 2003.

Methods

Analysis of annual hip fracture incidences in Germany was carried out using the national hospital discharge register and a correction factor of 0.89. Estimate of age–sex-adjusted changes was determined using the Poisson regression (incidence rate ratios, IRR; with 95 % confidence intervals, CI), overall and in age–sex–region strata.

Results

The number of patients with at least one hospital admission for hip fracture increased (1995: n = 99,146; 2010: n = 128,240). Overall, after adjustment for age, sex, and region, there was no significant trend during the observation period. However, in stratified analyses, a significant decrease was seen in people aged less than 40 years in both sexes and regions. Also, in women aged 60 years or older, the incidence decreased (Western Germany p = 0.001) or remained (Eastern Germany p = 0.053) (IRR 1995–2010, 95 % CI: 0.95, 0.92–0.98; and 1.05, 0.999–1.11). In contrast, the incidence in men 40–59 and 60 years older increased in both regions (West: 1.03, 0.97–1.09; and 1.11, 1.07–1.14; East: 1.12, 1.01–1.25; and 1.29, 1.22–1.36). While incidences were still significantly higher in Western Germany overall and in most strata, they tended to converge.

Conclusions

In line with most European countries, the overall hip fracture incidence in Germany no longer increases. However, differences between age, sex, and region exist.

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References

  1. Marks R (2010) Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009. Int J Gen Med 3:1–17

    PubMed Central  PubMed  Google Scholar 

  2. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA, for the IOF CSA Working Group on Fracture Epidemiology (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B (2011) Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int 22:2575–2586

    Article  CAS  PubMed  Google Scholar 

  4. Brown CA, Starr AZ, Nunley JA (2012) Analysis of past secular trends of hip fractures and predicted number in the future 2010–2050. J Orthop Trauma 26:117–122

    Article  PubMed  Google Scholar 

  5. Icks A, Haastert B, Wildner M, Becker C, Meyer G (2008) Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 19:1139–1145

    Article  CAS  PubMed  Google Scholar 

  6. Icks A, Haastert B, Meyer G (2007) Remarkable reduction in hip fracture incidence in younger ages in Germany. Am J Public Health 97:1733–1734

    Article  PubMed  Google Scholar 

  7. Wildner M, Clark DE (2001) Hip fracture incidence in East and West Germany: reassessment 10 years after unification. Osteoporos Int 12:136–139

    Article  CAS  PubMed  Google Scholar 

  8. Wilmoth JR, Andreev K, Jdanov D, Glei DA (2007) Methods protocol for the Human Mortality Database (version 5). Document of a series of discussions held in Rostock, Germany, and Berkeley, U.S.A. Available online as part of the Human Mortality Database (http://www.mortality.org/Public/Docs/MethodsProtocol.pdf)

  9. Scholz R, Jdanov D, Kibele E, Grigoriev P (2012) About mortality data for Germany. Available online as part of the Human Mortality Database (http://www.mortality.org/hmd/DEUTNP/InputDB/DEUTNPcom.pdf)

  10. Hoffmann F, Glaeske G (2006) Incidence of proximale femure fracture in Germany. Individual-based analysis of a statutory health insurance population. Gesundheitswesen 68:161–164

    Article  CAS  PubMed  Google Scholar 

  11. Icks A, Haastert B, Glaeske G, Stumpf U, Windolf J, Hoffmann F (2012) Correction factor for the analysis of the hip fracture incidence—differences between age, sex, region, and calendar year. Wien Klin Wochenschr 124:391–394

    Article  PubMed  Google Scholar 

  12. Johnell O, Gullberg B, Allander E, Kanis A, and the MEDOS Study Group (1992) The apparent incidence of hip fracture in Europe: a study of national register sources. Osteoporos Int 2:298–302

    Article  CAS  PubMed  Google Scholar 

  13. Korhonen N, Niemi S, Parkkari J, Sievänen H, Palvanen M, Kannus P. (2012) Continuous decline in incidence of hip fracture: nationwide statistics from Finland between 1970 and 2010. Osteoporos Int, 23: doi 10.1007/s00198-012-2190-8

  14. Cassell E, Clapperton A (2013) A decreasing trend in fall-related hip fracture incidence in Victoria, Australia. Osteoporos Int 24:99–109

    Article  CAS  PubMed  Google Scholar 

  15. Dimai HP, Svedbom A, Fahrleitner-Pammer A, Pieber T, Resch H, Zwettler E, Chandran M, Borgström F (2011) Epidemiology of hip fractures in Austria: evidence for a change in the secular trend. Osteoporos Int 22:685–692

    Article  CAS  PubMed  Google Scholar 

  16. Wu TY, Jen MH, Bottle A, Liaw CK, Aylin P, Majeed A (2011) Admission rates and in-hospital mortality for hip fractures in England 1998 to 2009: time trends study. J Public Health 33:284–291

    Article  Google Scholar 

  17. Leslie WD, O'Donnell S, Jean S, Lagacé C, Walsh P, Bancej C, Morin S, Hanley DA, Papaioannou A, Osteoporosis Surveillance Expert Working Group (2009) JAMA 302:883–889

    Article  CAS  PubMed  Google Scholar 

  18. Centers for Disease Control and Prevention (CDC) (2006) National trends in injury hospitalizations, 1979–2001. National hospital discharge survey. Available at: www.cdc.gov. Accessed March 23, 2007

  19. Kannus P, Niemi S, Parkkari J, Palvanan M, Vuori I, Jarvinen M (2006) Nationwide decline in incidence of hip fracture. Bone Miner Res 21:1836–1838

    Article  Google Scholar 

  20. Robert-Koch Institute (ed) (2006) National health report for Germany. RKI, Berlin

    Google Scholar 

  21. Schwabe U, Paffrath D (eds) (2005) Drug prescription report, Germany 2005. Springer, Heidelberg

    Google Scholar 

  22. Becker C, Cameron ID, Klenk J, Lindemann U, Heinrich S, König HH, Rapp K (2011) Reduction of femoral fractures in long-term care facilities: the Bavarian fracture prevention study. PLoS One 6(8):e24311

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Meyer G, Warnke A, Bender R, Mühlhauser I (2003) Effect on hip fractures of increased use of hip protectors in nursing homes: cluster-randomised controlled trial. BMJ 326:76–78

    Article  PubMed  Google Scholar 

  24. Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT (2002) Effect of birth cohort on risk of hip fracture: age-specific incidence rates in the Framingham Study. Am J Public Health 92:858–862

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank Dr. Janisch, Research Department of the National Statistical Office, for his support in data management. We also like to thank the MPI Rostock which provided us with HMD data.

Conflicts of interest

None

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Authors and Affiliations

  1. Department of Public Health, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstr. 59, 40225, Düsseldorf, Germany

    Andrea Icks & Werner Arend

  2. Robert-Bosch Clinic, Stuttgart, Germany

    Clemens Becker & Kilian Rapp

  3. MediStatistica, Neuenrade, Germany

    Burkhardt Haastert  (Burkhard Haastert)

  4. Clinic of Hand and Traumatic Surgery, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany

    Pascal Jungbluth  (Jungbluth P)

Authors
  1. Andrea Icks
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  2. Werner Arend
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  3. Clemens Becker
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  4. Kilian Rapp
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  5. Pascal Jungbluth  (Jungbluth P)
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  6. Burkhardt Haastert  (Burkhard Haastert)
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Corresponding author

Correspondence to Andrea Icks.

Appendix

Appendix

Table 2 Age–sex–region-specific standardized [age standardized rates using the finer age classes (0–29, 30–59 years of age; 10-year strata, 60–89 years of age; 5-year strata, last stratum 90+), same weights for males and females, standard population in Germany 2000] incidences of hip fractures in Germany, 1995–2010
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Icks, A., Arend, W., Becker, C. et al. Incidence of hip fractures in Germany, 1995–2010. Arch Osteoporos 8, 140 (2013). https://doi.org/10.1007/s11657-013-0140-5

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