Age-specific incidence of first and second fractures of the hip.
We determined the age-specific incidence of a second fracture of the hip and compared it with that of a primary fracture in a study population drawn from 6331 patients admitted to Nottingham University Hospital with a primary fracture of the hip over a period of 8.5 years. The incidence of a second fracture was determined using survival analysis. The mean age-specific incidence rates of primary hip fracture were calculated using census data. The overall incidence of a second fracture was 2.7% at one year and 7.8% at 8.5 years. That of a primary fracture was 50 per 100 000 in women aged 55 to 64 years rising to 3760 in those aged 84 years and over. The incidence of a second fracture in women aged 55 to 64 years was 2344 per 100 000. Patients of this age had a relative risk of 45 (95% confidence interval 13 to 155) for further fracture when compared with the population at risk of a first fracture. The incidence of a second fracture in women aged > 84 years was 2451 per 100 000 (relative risk 0.7, 95% confidence interval 0.5 to 0.9). A similar trend was seen in men. Patients sustaining a primary fracture of the hip between the ages of 55 and 64 years have a much greater risk of further fracture than the normal population, whereas those over 84 years have a similar risk. These findings have important implications for the provision of fracture prevention services in primary and secondary care.
Department of Trauma and Orthopaedics University Hospitals, Queens Medical Centre, Nottingham University Hospitals Trust, Nottingham NG7 2UH, UK.
T M
TM
Lawrence
R
R
Wenn
C T
CT
Boulton
C G
CG
Moran
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors